05/11/2009
Legal intelligence for professionals in health and social care
This Update contains brief details of recent Government publications, legislation, cases and other developments relevant to those involved in health and social care work, which have been published in the last month.
If you have been forwarded this update by a colleague and would like to receive it directly, please email Claire Bentley.
Care
Publications/Guidance
Identifying a fairer system for funding adult
social care. This briefing from the Joseph Rowntree Foundation
argues that analysts and commentators have paid insufficient
attention to equity in adult social care. It sets out a framework
for identifying a fairer system and uses this to evaluate the Green
Paper ‘Shaping the future of care together’.
NHS continuing healthcare and NHS-funded nursing
care: Public information booklet. Summary of information for
the public on NHS continuing healthcare and NHS-funded nursing
care, including details of what an individual should do if they
think they may be eligible.
NHS-funded nursing care practice guide (revised)
2009. Sets out the process for determining the eligibility for
NHS funded nursing care under the national framework for NHS
continuing healthcare and NHS-funded nursing care. It has been
revised in line with the revised national framework.
Consultations
Consultation on Care Quality Commission Strategy
for 2010-15. This consultation seeks views on the Commission's
five-year strategic plan.
If you wish to discuss any of the items raised in this section please contact Neil Grant.
Children
Publications/Guidance
Location,
location, location: making choice of place of birth a reality.
This report reveals the findings of research commissioned by the
National Childbirth Trust (NCT) to determine how many women have a
choice of where to have their baby and whether choice has become
more available in recent years. It also examines the importance of
choice of place of birth, the government policies supporting it and
reasons why that choice may not be available to some women. The NCT
makes recommendations to stakeholders to increase the options women
have when choosing where to have their baby.
Getting it right for children and families.
This guide is for health visitors and their teams, provider
managers, commissioners and educationalists. It sets out the
contribution that health visitors and teams can make to health and
wellbeing and public health.
Healthy Child Programme: pregnancy and the first
five years of life. This guide for PCTs, local authorities,
practice-based commissioners and providers of services in pregnancy
and the first years of life highlights the key role that the
Healthy Child Programme (HCP) (formerly known as the Child Health
Promotion Programme) plays in improving the health and well-being
of children, as part of an integrated approach to supporting
children and families. It sets out the recommended standard for the
delivery of the HCP and demonstrates how the programme addresses
priorities for children's health and well-being. The HCP for the
early life stages focuses on a universal preventative service,
providing families with a programme of screening, immunisation,
health and development reviews, supplemented by advice around
health, wellbeing and parenting. Delivery of the HCP depends on
services for children and families being fully integrated, and this
guide will inform joint strategic plans to promote child health and
wellbeing across all agencies.
Healthy Child Programme: the two year review.
This guide is a supplement to the updated guidance on the whole HCP
programme which was published in 2008. It draws together the latest
evidence on the health and development of two year olds and the
views of parents and practitioners, and reflects wider developments
in services for children and families such as Sure Start Children's
Centres and the Family Nurse Partnership programme.
Healthy Child Programme from 5 to 19 years old.
Sets out the recommended framework of universal and progressive
services for children and young people to promote optimal health
and wellbeing. It outlines suggested roles and responsibilities for
commissioners, health, education, local authority and other
partners to encourage the development of high-quality services. As
the Operating Framework for the NHS in England 2009/10 sets out,
PCTs will want to review the transparency of their service offer in
line with Healthy lives, brighter futures and local priorities, and
this may include the HCP.
News
Review of NHS children's services. The Chief
Executive of the NHS, David Nicholson, has commissioned Sir Ian
Kennedy to explore the cultural obstacles that can stand in the way
of sustained improvement in the provision of care for children and
to consider what can be done to develop the NHS’ contribution to
safeguarding children. For more details, see the Terms of Reference.
The new Vetting and Barring Scheme partially came into effect on 12 October 2009. From that date employers, local authorities, professional regulators and other bodies have a duty to make referrals to the Independent Safeguarding Authority where they consider a person has caused harm or posed risk of harm to children or vulnerable adults. The Scheme replaces the Protection of Vulnerable Adults (POVA) scheme and the Protection of Children Act (POCA) lists.
If you wish to discuss any of the items raised in this section please contact Penelope Radcliffe, Tracey Lucas or Deborah Jeremiah.
Clinical Management
Publications/Guidance
Delivering same-sex accommodation (DSSA):
principles. Lists the 17 principles that have been developed to
ensure each organisation delivers the highest standards of privacy
and dignity within all areas of a hospital, other trusts and
providers. The principles support existing DSSA policy and guidance
and aim to further clarify DSSA clinical definitions amongst
leaders and staff within the NHS. It is intended for the principles
to be used in conjunction with other guidance to drive forward
improvement and ensure sustainability within each organisation.
Bevan Brittan Updates
A round up of cases from Nicola Pegg covering issues
such as costs, provisional damages and limitation.
Good news on interim payments. Matt Trinder reports.
Injured and need care? – How to get it… Julie Chappell reviews the eligibility for state assistance available to injured patients.
If you wish to discuss any of the items raised in this section please contact Jackie Linehan.
Clinical Research
Publications/Guidance
New database to inform prioritisation of European
cancer research. A 'Database of Cancer Uncertainties' has gone
live on the NICE website. The database will collate details of the
major gaps in evidence which are identified during guidance
development. These evidence gaps can then be promoted as research
priorities to prospective research funders.
Decontamination of surgical instruments: Progress review 2008. This report has been updated to include much of the research presented at the twice yearly DECON meetings and published papers. The 2008 report will provide information for the DH with the aim of progressing these results from the research field into practical application within an NHS setting.
Consultations
The Human Fertilisation and Embryology Act 1990:
disclosure of identifying information for research: regulations for
consultation. The DH invites views on draft regulations
establishing a process for authorising the disclosure of
information retained by the Human Fertilisation and Embryology
Authority, for research purposes, where it is impractical to obtain
consent from the person to whom the information relates. The
regulations incorporate amendments made as a result of a previous
consultation exercise in January 2009. If approved the regulations
will enter into force on April 6, 2010. Comments by 2 December
2009.
News
New study to examine benefits of Personal Health
Budgets. The DH has announced 20 sites across England that have
been selected to participate in a study to identify the benefits of
Personal Budgets (PHBs) for health and the patient groups who will
benefit most from them. The study will be conducted through a
partnership between three existing research teams at three
institutions including the University of Kent. The full evaluation
will last three years, with newsletters, research summaries and
interim reports made available online. The press release includes a
list of the 20 sites and a case study demonstrating how PHBs are
transforming the lives of patients with long term conditions.
If you wish to discuss any of the items raised in this section please contact Claire Bentley.
Commissioning
Publications/Guidance
Commissioning local breastfeeding support
services. This commissioning guidance aims to assist
commissioners and PCTs in providing coherent services that will
promote breastfeeding and reduce inequalities.
Emergency services review. This report from the
Office of Strategic Health Authorities presents the findings of a
review of emergency services' recent performance and supports the
identification and adoption of best practice. The Emergency Care
Intensive Support Team, established by the review, is now
supporting the implementation of this guidance, hosting events and
supporting organisations to deliver the outcomes outlined in the
documents. The ESR Team has issued a series of supporting best
practice documentation, guides and toolkits alongside the
report.
Tackling demand together: a toolkit for improving
urgent and emergency care pathways by understanding increases in
999 demand. This toolkit has been produced by a group of
ambulance providers and primary care trust commissioners together
with the Department of Health to offer practical analysis,
worksheets and tools to help all commissioners and providers
improve urgent and emergency care services through better
understanding of the factors affecting significant rises in 999
demand.
The NHS as preferred provider. The Secretary of State's recent speech at the King's Fund focused on putting quality at the core of the NHS and assured that "the NHS is our preferred provider". This "Dear colleague" letter advises NHS Chief Executives on how the DH proposes to move this policy forward through the development of future guidance. There is also a letter from the SoS to the TUC General Secretary that lists the core principles which commissioners will be expected to follow, and suggests the process to be followed in a number of draft scenarios.
World class commissioning - an introduction. This guide provides a brief introduction to world class commissioning, which is about delivering better health and wellbeing for the population, improving health outcomes and reducing health inequalities. In partnership with local government, practice-based commissioners and others, PCTs, supported by SHAs, will lead the NHS in turning the world class commissioning vision into a reality, adding life to years and years to life.
If you wish to discuss any of the items raised in this section please contact David Owens.
Complaints
At Bevan Brittan we have set up an e-portal to assist complaints managers in the NHS. The portal is of use to all NHS complaints managers who are often handling very sensitive and complex work. It provides tailored access to a range of up-to-date knowledge and information enabling you to have a central, structured and focused source of information on complaints. It also has a discussion forum for use by clients to share tips and knowledge with each other. If you would like more information about the portal and the discussion forum please contact Claire Bentley.
Employment/HR
Publications/Guidance
Review Body on Doctors’ and Dentists’ Remuneration
for 2010. This document sets out all UK health departments'
written evidence in support of a pay review for doctors and
dentists in 2010.
New Guidance has been published dealing with the thorny issues of making severance payments to senior managers, who are generally covered by the Very Senior Managers Pay Framework. The guidance explains the process to be followed and includes draft templates for proposals to the remuneration committee, writing to the strategic health authority, and applying for HM Treasury approval.
Changes to consultants’ terms and conditions of service and corrigendum to M&D 1/2009. This is a pay circular informing the service of changes to the consultants' terms and conditions of service and a corrigendum to Annex A Section 7 of Pay Circular (M&D)1/2009 to correct an earlier rounding error in the Associate Specialist 2008 locum rates. The changes are effective from 1 September 2009.
The Government's response to the Health Select Committee's report on the use of management consultants in the NHS and the Department of Health. In June 2009 the Commons Health Committee published a report on the use of management consultants in the NHS and DH that examined the amount spent by the NHS on management consultants and whether they were obtaining value for money from those contracts. This document sets out the Government's response to the Committee's recommendations on the collection of detailed information on NHS expenditure and use of management consultancy, and the need for the improved management and assessment of value from those consultancy services.
Achieving age equality in health and social care. In April 2009, the then Secretary of State for Health commissioned a review of age discrimination and age equality in the health and social care sector. The review analysed evidence about the nature, extent and variability of age discrimination in health and social care services. It also considered what reforms are already in train to tackle age discrimination and support greater age equality. It looked at evidence from a wide variety of sources, including academic research, stakeholder submissions, personal testimony and the conclusions of a number of workshops and engagement events. A report of this review has been published.
NHS Employers submission to the NHS Pay Review Body
2010/11. This document presents NHS Employers' evidence to the
NHS Pay Review Body for the 2010/11 pay round. It outlines key
messages to the review body made on behalf of NHS organisations in
England. It provides background information on the multi-year
settlement for Agenda for Change staff; a section about the review
clause; recruitment and retention and affordability.
Survey on 48 hour week Working Time Directive
readiness. This report details a survey to review the readiness
of NHS trusts for the introduction of the European Working Time
Directive 48 hour working week in August 2009. The document was
commissioned by DH in November 2008 and represented data collected
in January 2009.
Medical Training Initiative (MTI) guide. This guidance
is designed to allow overseas doctors to undertake up to two years
of training and experience in the UK. It explains the benefits of
the MTI and signposts additional information.
Senior Salaries Review Body: Review for 2010 -
Written evidence from the Department of Health. This written
evidence supports efforts to set salaries at the right levels to
recruit, retain, and motivate sufficient numbers of high quality
leaders and managers to deliver Government policy for the benefit
of patients, and to do so in a manner that is affordable in both
the short and longer terms.
Women doctors: making a difference. This report from the National Working Group on Women in Medicine highlights current barriers that prevent female practitioners in the medical profession from reaching senior positions and leadership roles and sets out recommendations on how best to address these. The report is a direct response to the concern raised in the Chief Medical Officer's 2006 Annual Report that despite there being an increase in the number of females entering the profession over the last 20 years, few have reached senior leadership positions compared to their male counterparts. The Working Group was chaired by Baroness Ruth Deech.
Patients are being harmed by working time limits, finds RCS study. The RCS has published the findings from its survey of 900 surgeons about the impact of the European Working Time Directive (EWTD), which aims to restrict weekly working hours to no more than 48 hours. The sample is comprised of 'more than' 360 consultants and 'more than' 500 trainees. Key findings include: 62 per cent confirmed that the service/specialty within which they work was currently compliant with EWTD; 70 per cent estimated they were working in excess of the 48 hour limit; 44 per cent felt that compliance had only been attained 'at the expense of patient safety' and 64 per cent believed quality of care had suffered as a result of EWTD.
NHS Employers has produced revised FAQs for employers on the Working Time Directive. The revised FAQs include new information on where an opt-out might be appropriate, how locum doctors' hours should be counted, and indemnity arrangements.
New FAQs for employers re Pandemic Flu have also been produced dealing with tricky issues such as the use of students and retired staff during the flu pandemic. The FAQs are the result of discussion with NHS organisations, the Department of Health and key stakeholders.
NHS Employers has published a new online guide on the current UK equality and diversity legislation for employers. The online guide looks across the eight diversity strands, outlining what the legislation is and what employers need to do. It also sets out shared learning from trusts and sources of further information, including the full legal texts.
Bevan Brittan Updates
Age Discrimination: Further cases on objective
justification. Two recently published age discrimination cases
have provided some, if not total, clarity on the issue of
justification in age discrimination claims. Sarah Lamont explains
more.
“Bank” workers NOT employees… .The vexed question of whether a “bank” worker is actually an employee has troubled HR professionals and employment lawyers alike for many years. A decision of the Employment Appeal Tribunal, earlier this year, appears to have provided a definitive answer, but is this the end of the story? Mike Smith explains more.
Pension Quality Mark – Good for employers and employees. On 21 September 2009 the National Association of Pension Funds (NAPF) introduced the Pension Quality Mark (PQM) - a certificate, similar to the kite mark, which confirms that the company’s defined contribution (“DC” or “money purchase”) pension scheme has met the key qualifying criteria on contribution rates, governance and communications. Christine Johnston explains more.
News Round-up. Lara Feghali reports on the latest developments in employment law including details of the increased “Vento” guideline payments for injury to feelings awards, news that the Civil Service is to end forced retirement at 65, confirmation that there is to be no change to statutory sick pay (SSP) in respect of a pandemic flu outbreak, information on a new code of practice on tips and service charges, confirmation that tax relief on child care vouchers is to be abolished and details of the Tribunal statistics for 2008/09.
Events
Public sector employment law workshop.
If you wish to discuss any of the items raised in this section please contact Sarah Michael
Finance
Publications/Guidance
Auditors’ local evaluation and use of resources
2008/09: summary results for NHS trusts and primary care
trusts. Each year the Audit Commission assesses how well NHS
trusts and PCTs manage their resources and deliver value for money.
For 2008/09, these assessments have been based on the Auditors'
Local Evaluation for NHS trusts and use of resources for PCTs. This
national report outlines the scores and how they should be viewed
in the context of the overall financial performance of the NHS in
2008/09.
If you wish to discuss any of the items raised in this section please contact Claire Bentley.
Foundation Trusts
Publications/Guidance
Guide to Monitor for NHS foundation trust
governors. Sets out what Monitor does, how it regulates FTs and
how governors can interact with Monitor.
Monitor has published 5 toolkits on service line reporting.
Your statutory duties: a reference guide for NHS foundation trust governors. Examines ways in which NHS FT governors can deliver their statutory duties. It sets out these duties, and provides suggested advisory process steps to deliver them, which reflect best practice. The guide was produced following a 12-week consultation process.
Consultations
Consultation on additional annual reporting requirements
2009/10. This consultation document sets out proposals for
additional annual reporting requirements for NHS foundation trusts
for 2009/10. The proposals in the consultation cover five main
categories of reporting:
1. Quality;
2. Sustainability;
3. Valuing people
- Equality and diversity
- Staff feedback;
4. NHS Constitution; and
5. Regulatory findings.
The consultation document includes the examples of the proposed format of reporting in each of the above five categories, and indications as to how reporting requirements in each of these, and the related assurance, may be likely to develop. Monitor is consulting on these proposals in order to:
1.finalise guidance for the 2009/10 quality accounts (as
anticipated in the NHS Foundation Trust Financial Reporting Manual
for 2009/10, section 7.72);
2. include reporting requirements against the NHS Constitution;
and
3. further develop the reporting requirements in line with best
practice (i.e. incorporating elements of Corporate Social
Responsibility reporting).
These proposals, if agreed, will be for inclusion in the 2009/10
annual reports and accounts of NHS foundation trusts. This
consultation closes at 5pm Monday 25 January 2010.
Response to consultation on the de-authorisation of
NHS foundation trusts. Sets out the DH's response to the July
2009 consultation on proposed changes that would enable Monitor and
the Government to de-authorise failing NHS FTs and remove
foundation status. It summarises the responses received, and
outlines the Government's intention to take action as part of the
Health Bill currently before Parliament.
If you wish to discuss any of the items raised in this section please contact Vincent Buscemi.
Governance
Publications/Guidance
18 weeks - next steps. This letter to SHA Chief
Executives outlines outlines the steps necessary to the success of
the 18 weeks pledge.
If you wish to discuss any of the items raised in this section please contact Claire Bentley.
Health and Safety
Publications/Guidance
Managing patients’ medicines after discharge from
hospital. The Care Quality Commission has published findings
from its study of how well patients’ medication is managed after
leaving hospital. It visited 12 PCTs, as commissioners of GP and
hospital care, and surveyed 280 of their GP practices. The report
suggests that the NHS may be at risk of failing to prevent harm to
patients from medicines unless it improves sharing of vital
information when people move between services.
The Government response to the Health Select Committee Report 'Patient Safety'. Sets out the Government's response to the House of Commons Health Select Committee's Report on Patient Safety, published on 3 July 2009.
News
Completion of reform to the healthcare regulatory
bodies. The DH has announced the completion of reforms that
mark a significant milestone in the Government’s programme to make
safety and quality paramount in the care of patients by modernising
the regulation of healthcare professionals, as set out in the White
Paper "Trust, Assurance and Safety". The key features of the
reforms are: each regulator has moved to a fully appointed council,
with parity between lay and professional members, to ensure that
professional interests do not dominate; new council members for the
regulators will be independently appointed by the Appointments
Commission against specific criteria relating to their skills and
expertise; and smaller, more board-like councils will enhance the
ability of the regulators to act strategically.
If you wish to discuss any of the items raised in this section please contact Adam Kendall.
Healthcare Associated Infection
Publications/Guidance
The Max4Health hand hygiene campaign. This
report sets out the results of an evaluation of the Max4Health hand
hygiene campaign undertaken at Southampton University Hospitals NHS
Trust over a nine week period between February and April 2009.
If you wish to discuss any of the items raised in this section please contact Sian Morgan.
Inquests
Publications/Guidance
Coroners and Justice Bill: a parliamentary briefing
paper prepared for Report Stage in the House of Lords on October
21, 2009. This paper sets out the views of the Bar Council and
the Criminal Bar Association on key aspects of the Coroners and
Justice Bill 2009 ahead of the Report Stage in the House of Lords,
which started on 21 October 2009.
Bevan Brittan Updates
The Coroners and Justice Bill. The draft Coroners
Bill was initially published in June 2006 for the purpose of
delivering a better service for bereaved people and those who
interact with the coroner’s service, to introduce national
leadership for the service and to ensure that inquests and
investigations undertaken by coroners are more effective. Tracey
Lucas reviews the position.
If you wish to discuss any of the items raised in this section please contact Joanna Lloyd or Nadia Persaud.
Mental Health
Publications/Guidance
CQC 2009 survey of mental health acute inpatient
services. The Care Quality Commission 2009 survey of people who
had recently had an inpatient stay for acute mental health problems
was the first of its kind and collected responses from over 7,500
people. The survey asked people all about their experiences of
acute inpatient mental health services along the pathway from
admission to leaving hospital, including the care and treatment
they received, day-to-day activities, and relationships with
staff.
Supporting Learning Disability Partnership Boards
to implement the National Carers Strategy. This booklet offers
guidance to learning disability partnership boards to help them
ensure that carers of people with learning disabilities and carers
with learning disabilities are supported in their own right and
involved in local service developments that affect their lives and
the lives of the people they care for.
The Mental Capacity Act: Fact sheet for social
scientists. This is a fact sheet to assist social scientists in
meeting the requirements of the Mental Capacity Act when carrying
out social science research that includes people who lack
capacity.
A summary of changes to direct payments. This leaflet sets out changes to the direct payment scheme that will take effect from 9 November 2009. The changes will extend the scheme to people who lack the capacity to consent and people with mental health problems who are subject to mental health and certain criminal justice legislation.
Supporting people with autism through adulthood.
Published by the House of Commons Public Accounts Committee, this
report looks at developing a strategy and services for adults with
autism, autism awareness and access to services, and improving the
effectiveness of services for adults with autism.
Absent without leave: definitions of escape and
abscond. Definitions of escape, attempted escape, abscond and
failure to return in secure mental health services.
News
Improved forms and clearer guidance to help you
protect your future. The Office of the Public Guardian (OPG)
has introduced shorter and simpler forms to organise a lasting
power of attorney (LPA). The forms, which must be registered with
the OPG for a fee of GBP 120 per form, cover property and financial
affairs, and are improved versions of October 2007 forms; LPAs can
still be made on previous forms until 31 March 2011.
If you wish to discuss any of the items raised in this section please contact Simon Lindsay.
Pandemic Influenza
Publications/Guidance
Stock Management System training manuals. The
Stock Management System (SMS) provides users with an effective tool
to manage the distribution of antivirals to PCTs and collection
points in the event of a pandemic. It will provide stock level
information, reports and the ability to record issuance from GP
prescribed antiviral information. These training manuals are to
provide guidance to users of the SMS for antivirals.
Swine flu clinical package. This is a set of
tools for use by frontline healthcare professionals, in severe and
exceptional circumstances, during a pandemic flu situation.
Guidance on sickness certification in response to
the swine flu pandemic. This document clarifies that the
existing arrangements for provision of medical certificates or
self-certification have not changed in light of the swine flu
pandemic. The situation is being kept under close review to enable
action to be taken quickly, should it be necessary.
The H1N1 swine flu vaccination programme
2009-2010. This letter provides information to assist
immunisation leads, pandemic influenza leads and flu co-ordinators
in further planning for the swine flu (influenza A (H1N1v) 2009)
vaccination programme.
Rotation of doctors in training during pandemic
influenza. As part of ongoing organisational preparedness, Ian
Dalton, National Director of NHS Flu Resilience and Pat Hamilton,
Director of Medical Education (England) have written this letter
outlining arrangements for the rotations of doctors in training in
the event of serious pandemic flu. It is accompanied by a paper by
Prof David Sowden, the Pandemic Flu educational advisor to the
Department of Health, and a statement of support from the
Postgraduate Medical and Education Training Board (PMETB).
Pandemic influenza: Additional measures to meet
workforce supply. This document summarises the agreed
arrangements on issues such as re-registration, professional
indemnity and pre-employment checks that will enable local
employers to quickly recruit appropriately qualified health
professionals if they should be needed to deal with pandemic
influenza.
Pandemic Influenza: Recommendations on the use of
antiviral medicines for pregnant women, women who are breastfeeding
and children under the age of one year. Gives information on
the dose of oseltamivir for children aged six months and over and
up to one year of age and treatment of pregnant women.
A (H1N1) Swine influenza: Additional planning
guidance and winter management and reporting for 2009-10. This
is a letter to NHS chief executives explaining the latest guidance
to support pandemic planners based on the latest science and
understanding of the swine flu virus, and to ensure that all
organisations continue to plan for managing swine flu alongside the
added pressures of winter.
A (H1N1) Swine influenza: Additional planning guidance. This is
a letter to Directors of Adult and Children's Services explaining
the latest guidance to support pandemic planners based on the
latest science and understanding of the swine flu virus, and to
ensure that all organisations continue to plan for managing swine
flu alongside the added pressures of winter.
Swine flu: guidance for planners. This updated
guidance has been published to support pandemic planners based on
the latest science and understanding of the swine flu virus.
A (H1N1) Swine Influenza: Vaccination programme
update. A letter from Ian Dalton, National Director of NHS Flu
Resilience, to NHS Chief Executives, providing further information
on the swine flu vaccination programme.
The H1N1 swine flu vaccination programme
2009-2010. Letter providing information to assist immunisation
leads, pandemic influenza leads and flu co-ordinators in further
planning for the swine flu (influenza A (H1N1v) 2009) vaccination
programme.
Swine Flu Vaccination Programme: Information to
support the vaccination of pregnant women. This is a letter to
GPs and practice nurses introducing a questions and answers
document and other information materials.
Clinical professionals brief on swine flu
vaccination. This paper aims to provide clinicians with further
information about the swine flu vaccination programme. It combines
information about the vaccines and the proposed programme for their
administration from the Department of Health with evidence from a
variety of peer-reviewed sources.
Vaccination (H1N1 Swine) for Health Protection
Agency Staff. This is a letter from National Director of NHS
Flu Resilience Ian Dalton requesting assistance in the vaccination
of Health Protection Agency staff.
H1N1 swine flu vaccination programme: information
materials and vaccine schedule information. This dear colleague
letter outlines the information materials for the H1N1 swine flu
vaccination programme that are now published on the Department of
Health website.
Legislation
The Primary Medical Services (Directed Enhanced
Services - pandemic influenza (H1N1) vaccination scheme) and
Statement of Financial Entitlements (Amendment) (No.6) Directions
2009. These Directions require PCTs to offer to enter into a
Directed Enhanced Service with their existing primary medical care
contractors who hold a list of registered patients, by 13 November
2009, to deliver the H1N1 vaccine to patients in the priority
groups identified in the CMO letter of 13 August 2009.
If you wish to discuss any of the items raised in this section please contact Claire Bentley.
Primary Care Trust
Publications/Guidance
General practice in England: an overview. This
briefing from the King's Fund sets out how general practice is
organised, contracted and financed, analyses the impact of recent
government policy, and looks at future trends.
Improving quality in primary care. Practical
guide to support PCTs, as commissioners of primary care, in working
with local clinicians and other stakeholders, including patients,
to promote continuous quality and productivity improvement in
primary care services.
Out-of-hours primary care services: Primary care
trusts' contract and performance management arrangements. This
letter to PCTs in relation to the Care Quality Commission's
independent inquiry into provision of out-of-hours GP services
reiterates that PCTs have a legal obligation to make sure OOH
services are delivered safely and to a high standard.
Reviewing patients who have waited longer than 18 weeks. As set out in David Flory's Quarter 4 2008-09 report, PCTs need to understand and act upon the reasons for any unnecessary waits over 18 weeks. This guidance suggests methods for reviewing and reporting waits longer than 18 weeks in order to understand the causes of unnecessary waits, and to drive further improvements in patient experience.
Legislation
Primary Care Trust Medical Services Directions
2009.These Directions are given to PCTs in England and came
into force on 17 September 2009. They revoke and replace the
Primary Care Trust Medical Services Directions 2008.
Alternative Provider Medical Services Directions 2009. These Directions have been given to PCTs in England and came into force on 17 September 2009.
News
Patients to rate GP practices online. The DH
has launched a new online comparison service that will give people
all the information they need to decide which of England's 8,300
practices is right for them, to enable them to register with a GP
practice of their choice. The tool will make it easier to find key
information in one place, such as opening times and additional
facilities offered by the GP practice. Patients will also be able
to read other people’s comments about the quality of the GP
service.
Secretary of State for Health Andy Burnham has announced that NHS patients are to be legally entitled to receive private treatment if they are not seen within the 18 week waiting time target. Cancer patients will also receive funding for private treatment if they have not seen an NHS specialist within two weeks of GP referral. The two legal rights are designed to entrench the reduction in waiting times over recent years and prevent waiting lists growing. The waiting times are due to be placed on the statute book for the first time and will be passed through parliament before the next general election. Mr Burnham said the move would embed patients' rights and will be a "key battleground for the next election."
If you wish to discuss any of the items raised in this section please contact David Owens.
Regulation
Publications/Guidance
Guidance: Sharing information gained during
regulatory activity. Provides guidance on how the Care Quality
Commission shares information about service providers with
commissioners of care, such as councils, PCTs and other
organisations.
Performance ratings 2008/09. The CQC has published the performance ratings for all 392 NHS trusts in England. The assessment, also known as the ‘annual health check’, shows big improvements for patients in areas such as accident and emergency waiting times, treatment referral times, and chlamydia screening rates, and big reductions in MRSA and C. difficile cases. But CQC raises concerns about the 20 trusts rated "weak” this year on quality and a further 27 that have not been higher than “fair” for quality and financial management in the last four years.
Guide to Monitor for NHS foundation trust governors. Sets out what Monitor does, how it regulates FTs and how governors can interact with Monitor.
Your statutory duties: a reference guide for NHS foundation trust governors. Examines ways in which NHS FT governors can deliver their statutory duties. It sets out these duties, and provides suggested advisory process steps to deliver them, which reflect best practice. The guide was produced following a 12-week consultation process.
Cases
Gerstenkorn v General Medical Council (Unreported, 12 October 2009)
(Admin Ct). The court held that the GMC's Fitness to Practise Panel
was entitled to find that a consultant renal transplant surgeon's
fitness to practise was impaired by reason of his misconduct and
deficiency in his professional performance, and the erasure of his
name from the medical register was the appropriate sanction.
Ndisang v Nursing and Midwifery Council [2009] EWHC 2487 (Admin)
(Admin Ct). The court held that, where the Nursing and Midwifery
Council's Conduct and Competence Committee had incorrectly found a
charge of misconduct against a nurse in a care home who had given
the key of a drug cupboard to a care worker, there was no proper
basis to interfere with its decision that the nurse's fitness to
practise was impaired and to make a caution order against him, as
the charge made no material difference to the Committee's
considerations in reaching its decision.
Muscat v Health Professions Council [2009] EWCA Civ
1090 (CA). The court held that the existence of a right to
review was a factor to be taken into account by the court when
exercising its discretion as to whether to admit fresh evidence on
appeal. In this case, that diminished the importance of the public
interest in not striking off a qualified health professional.
S v Health Professions Council (Unreported, 23 October 2009) (Admin
Ct). The court held that a period of 16 months between the initial
hearing of a complaint about the conduct of a healthcare
professional by the Health Professions Council’s Conduct and
Competence Committee, and the final hearing at which he was struck
off, did not give rise to a breach of his right to a fair trial
under art.6(1) ECHR. The process had been conducted expeditiously
and fairly.
Consultations
Response to the consultation on draft regulations
for the framework for the registration of health and adult social
care providers. In spring 2009, the Department of Health
consulted on a set of draft regulations, which set out the detail
of a new registration system to be operated by the new Commission.
This document provides the response to the consultation.
Consultation on Care Quality Commission Strategy for 2010-15. This consultation seeks views on the Commission's five-year strategic plan.
Legislation
Draft Health and Social Care Act 2008 (Regulated
Activities) Regulations 2009. These draft regulations detail
the new framework against which the Care Quality Commission will
regulate providers of health and adult social care. The
requirements set out the essential levels of safety and quality of
care that providers must deliver for people who use their services,
but gives them flexibility on how they do it. Subject to
approval by Parliament, the new system will be introduced for NHS
healthcare providers in April 2010 and for private and voluntary
health care and adult social care providers from October 2010,
making it illegal for organisations to provide services that fall
under the new framework without registering.
News
Completion of reform to the healthcare regulatory
bodies. The DH has announced the completion of reforms that
mark a significant milestone in the Government’s programme to make
safety and quality paramount in the care of patients by modernising
the regulation of healthcare professionals, as set out in the White
Paper "Trust, Assurance and Safety". The key features of the
reforms are: each regulator has moved to a fully appointed council,
with parity between lay and professional members, to ensure that
professional interests do not dominate; new council members for the
regulators will be independently appointed by the Appointments
Commission against specific criteria relating to their skills and
expertise; and smaller, more board-like councils will enhance the
ability of the regulators to act strategically.
The Care Quality Commission (CQC) is encouraging NHS
employees to provide feedback on their experiences at work by
participating in the seventh annual NHS Staff Survey.
If you wish to discuss any of the items raised in this section please contact Neil Grant.
General
Publications/Guidance
Independent sector treatment centres.
Independent sector treatment centres (ISTCs) provide services to
NHS patients but are owned and run by organisations outside the
NHS. This briefing paper explains why ISTCs were introduced, and
how they are funded, staffed and regulated. It assesses their
impact so far, including the quality of their services and whether
they provide good value for money. Finally, it examines what their
future may be now that the contracts ISTC providers hold with the
Department of Health are beginning to expire.
Reclaiming costs of visitor treatment from European Economic Area (EEA) member states. From 12 October 2009 the DH has changed the arrangements which NHS trusts should follow in recording and reporting treatments (including planned treatments) of visitors from the EEA and Switzerland. This letter gives more information.
Access to healthcare abroad. Informs tells
citizens about how they can get healthcare in other countries in
the European Economic Area.
Guidance on changes to recording and reporting data
about necessary and planned treatment of overseas visitors from the
European Economic Area (EEA). This letter advises on changes to
be made to the collection and reporting of data about overseas
visitors from 12 October 2009, with detailed guidance about the
processes, and information about future workshops. See also
Leaflets on the European Health Insurance Card,
healthcare entitlement for European Economic Area and non-European
Economic Area visitors and hospital treatment for non-resident UK
citizens - part of a suite of information for overseas visitor
managers in support of the new arrangements by which NHS trusts
should record and report treatments (including planned treatments)
of visitors from the EEA and Switzerland.
The CRC energy efficiency scheme and the NHS.
The Carbon Reduction Commitment energy efficiency scheme, which
will begin in April 2010 with an introductory three-year phase, is
a mandatory energy efficiency scheme that will affect both the
public and the private sector. This Briefing outlines the main
details of the scheme which will affect NHS trusts.
International health: Department of Health (DH)
objectives and ways of working. This is a guide primarily for
DH staff, to help DH work more effectively internationally. It sets
out objectives for their international work and describes the roles
and responsibilities of different parts of DH. The role that the DH
has in taking forward the government's global health strategy is
also discussed. The publication describes some of the key partners
and international organisations that they work with.
Working together to save lives: the Organ Donation Taskforce Implementation Programme's annual report, 2008/09. This first annual report of the ODTIP details the progress made in the first year of the Programme, which was set up by the Government to increase organ donation by more than 50% by 2013 with the aim of enabling the NHS to carry out more than 1,400 extra transplants every year. The Programme aims to do this by implementing the 14 recommendations of made by the Organ Donation Taskforce in January 2008. The report shows progress that has been made since the implementation team began its work in June 2008, particularly the changes in structures and arrangements in the NHS with the move to a centrally managed, and enlarged, network of Donor Transplant Coordinators and the appointment of Clinical Leads for Organ Donation within hospital trusts.
Managing patients' medicines after discharge. This CQC report looks at how well patients' medication is managed after leaving hospital. During its visits, the CQC saw some evidence of good practice, but also found the following concerns: GP practices and hospitals do not always share timely, complete patient information on medication changes when people move between services; reviewing and updating of GP records is sometimes left to administrative staff; GPs do not routinely review new medication with a patient after they leave hospital; and monitoring and learning from serious incidents is patchy. From April 2010, all trusts will be required by law to register with CQC and must meet a new set of standards. Effective management of medicines will be a requirement of registration, and CQC will take action where trusts fall short of meeting this. The regulator therefore urges all trusts and GP practices to use the findings of its study to identify problem areas in preparation for registration.
Consultations
Prioritisation for quality improvement: National
Quality Board stakeholder engagement. The Department of Health
seeks views on the proposed process by which the National Quality
Board will advise the Government on clinical priorities and on
topics for National Institute for Health and Clinical Excellence
quality standards. Comments are required by 10 November 2009.
The Human Fertilisation and Embryology Act 1990:
disclosure of identifying information for research: regulations for
consultation. The regulations establish a procedure for
authorising the disclosure of identifying information held by the
Human Fertilisation and Embryology Authority, for research
purposes, where it is not practicable to obtain consent to the
disclosure from the persons to whom the information relates. This
is the second consultation exercise and covers the amendments made
to the draft regulations as a result of the responses received to
the first consultation exercise that took place at the start of
2009. Responses should be submitted by 2 December 2009.
Direct payment for health care: a consultation on proposals for regulations and guidance. Seeks views on proposals for piloting direct payments for health care, as part of the wider pilot programme to explore personal health budgets announced in High Quality Care For All. Personal health budgets are intended to help create a more personalised NHS by giving people more control over their care. PCTs are already able to offer personal budgets that do not involve giving money directly to individuals. The Health Bill, which has now completed its main Parliamentary stages and should receive Royal Assent shortly, extends these options by providing power to allow direct payments, where the individual would be given the money to buy their own health care as agreed in a care-plan. This consultation will inform the regulations and guidance to make direct payments happen. The consultation closes on 8 January 2010.
Protecting the NHS in relation to patient mobility
and cross-border healthcare: Draft regulations and guidance.
ECJ case law on patient mobility under Article 49 of the EU Treaty
means that patients are able to seek any healthcare (including
private care) in another European Economic Area (EEA) Member State,
and, as long as they are entitled to the treatment in question
under their home healthcare system, they are eligible to have their
costs reimbursed. For patients travelling from the UK, this
reimbursement can be up to the level of the cost for the same
treatment provided in the UK under the NHS. Any additional costs
must be met by the individual. Patients from EEA countries can
likewise pay to receive NHS treatment and claim reimbursement from
their home health system. The DH is seeking views on the content,
clarity and appropriateness of the draft regulations and draft guidance on prior authorisation and
reimbursement of costs in respect of applications from patients to
access cross-border healthcare under the provisions of Art.49 EU.
The stakeholder consultation runs until 20 November 2009 and the
new regulations and guidance should come into force in January
2010.
The DH is holding an NHS stakeholder engagement event on 19 November
2009 on the proposed interim regulations and guidance.
Legislation
Human Fertilisation and Embryology Act 2008
(HFEA). This Act came into force on 1 October 2009. It: ensures
all human embryos outside of the body are subject to regulation;
ensures regulation of human admixed embryos; bans sex selection for
non-medical reasons; recognises same sex couples as legal parents
of children conceived through use of donated sperm, eggs or
embryos; replaces the reference to "the need for a father" with
"the need for supportive parenting"; revises rules on the use of
HFEA collected data; and extends storage time of embryos to up to
55 years.
National Health Service (Free Prescriptions and
Charges for Drugs and Appliances) (Wales) (Amendment) Regulations
2009 (SI 2009/2607 (W.21)). These regulations, which come into
force in Wales on 20 October 2009, amend SI 2007/121 (W.11), which
abolished charges in respect of drugs and appliances supplied to
patients registered with GPs in Wales, or registered with GPs in
England and who hold a valid entitlement card. These regulations
broaden the list of medical conditions which entitle a patient to
apply for a certificate which exempts that patient from the
requirement to pay a charge, to include cancer, the effects of
cancer and the effects of cancer treatment.
News
Secretary of State for Health Andy Burnham has announced that NHS
patients are to be legally entitled to receive private treatment if
they are not seen within the 18 week waiting time target. Cancer
patients will also receive funding for private treatment if they
have not seen an NHS specialist within two weeks of GP referral.
The two legal rights are designed to entrench the reduction in
waiting times over recent years and prevent waiting lists growing.
The waiting times are due to be placed on the statute book for the
first time and will be passed through parliament before the next
general election. Mr Burnham said the move would embed patients'
rights and will be a "key battleground for the next election."
Bevan Brittan Updates
Assisted Suicide: A Step Towards a More Compassionate
Law? A review of R (on the application of Purdy) v DPP (2009)
UKHL 45 & DPP Guidelines.
Events
Medical law: annual prison health update
If you wish to discuss any of the items raised in this section please contact Claire Bentley.
