Health and Social Care Update - October 2009

This Update prepared by Claire Bentley 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.

06/10/2009

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   Health and Safety
  Children   Healthcare Associated Infection
  Clinical Management   Inquests
  Commissioning   Mental Health
  Data Protection   Pandemic influenza
  Employment/HR   Primary Care Trust
  Finance   Prison Health
  Foundation Trusts   General
 
 

 

Care

Publications/Guidance
IDeA: Commissioning for carers. This document, intended primarily for local NHS and council commissioners in England, covers the commissioning of adult services that impact adult carers, including services for the people whom carers look after.

Supporting carers to care. This report examines the steps the Department of Health has taken to improve the delivery of benefits to carers and the support it provides to help them find employment.

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, as from 1 October 2009. It has been revised in line with the revised national framework.

Integrated care pilots - an introductory guide. The DH has launched a pilot programme to test and evaluate a range of models of integrated care. The programme of Integrated Care Pilots is designed to explore different ways in which health and social care could be provided to help drive improvements in local health and well-being. ICP allows communities to take a fresh look at how to deliver such care, based solely around the needs of the local population. The aim is to look beyond traditional boundaries (e.g. between primary and secondary care) to explore new, integrated models. This guide provides a summary of the work each pilot will be doing as they implement and test their models of integrated care.

Managing influenza-like illness (ILI) in nursing and residential homes during the current influenza pandemic (WHO phase 6). This guidance aims to provide advice on the generic management of cases or outbreaks of flu-like illness in nursing and residential homes, and provides specific guidance appropriate to pandemic (H1N1) 2009 influenza.

Integrating care and transforming community services: what works? where next? This paper follows on from a seminar organised by the Health Services Management Centre earlier this year. It summarises the presentations made at the seminar and considers the implications for policy makers and practitioners, noting the increasing interest in integrated care given the context of an ageing population and the increasing burden of chronic disease. The authors note that while integrated care may not be the only solution, it has an important role to play in ensuring quality and the effective use of resources.

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.

Legislation
Continuing Care Directions. The DH has issued three Directions to give statutory effect to key elements of the revised National Framework for NHS Continuing Healthcare and NHS-funded Nursing Care:
  National Health Service (Nursing Care in Residential Accommodation) (Amendment) (England) Directions 2009;
  Delayed Discharges (Continuing Care) Directions 2009; and
  NHS Continuing Healthcare (Responsibilities) Directions 2009.

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.

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Children

Publications/Guidance
Aiming high for disabled children: delivering improved health services. This report examines best practice around the country. It draws on examples of services for disabled children that meet users’ needs, respond to the government agenda and are effective from both a quality and a cost point of view.

Nurse-Family Partnership programme - second year pilot sites implementation in England: the infancy period. This DCSF report is the second year report of a four year evaluation study that is assessing the feasibility of delivering the Family Nurse Partnership (FNP) programme in England. The FNP programme has £36m funding to provide intensive support for vulnerable first time young mothers and their families: specially trained nurses work with them from early pregnancy until the child is two years old, building close relationships and guiding them towards adopting healthy lifestyles for themselves and their babies. The report focuses on the infancy phase of the programme, addressing how it can be delivered with consistency, fidelity to the US programme model attained, its acceptability to clients, their engagement and retention as well as FNP in the wider children's service context and its costs. It finds that the FNP programme is helping young first time mothers to improve the life chances of their babies and helping fathers to be more involved in the early years of their children's lives.

Progress on improving maternity services. This letter outlines the Department of Health’s expectations of what the NHS will have achieved in maternity services by the end of 2009.

Delivering high quality midwifery care: the priorities, opportunities and challenges for midwives. The Next Stage Review (NSR) placed the midwifery profession at the centre of the maternity care pathway, with unparalleled opportunities to drive up the quality of care for women, babies and their families. Quality of Midwifery Care Project policy context. This report has been produced from the work of the Quality of Midwifery Care Project steering group and its sub-groups of midwives, lay representatives and other stakeholders in response to the NSR and reflecting on the policy direction of Maternity Matters. It considers the opportunities, priorities and challenges for midwives as they use the impetus of the NSR to promote consistent high quality services delivered by a high-quality workforce.

Reducing differences in the uptake of immunisations. NICE has published guidance on the uptake of immunisations (including targeted vaccines) in people younger than 19 years. The guidance aims to tackle inequalities across England by offering practical recommendations to increase the number of children and young people who are up-to-date with their vaccinations.

Parental experience of services for disabled children - qualitative research (phase 2): exploring the findings from the national survey. This research sets out findings from a second phase of qualitative work looking at parental experiences and views of services they use in relation to their disabled child. This work was intended to explore some of the key findings from the survey in more depth by providing evidence to help understand how services can be improved.

If you wish to discuss any of the items raised in this section please contact Penelope RadcliffeTracey Lucas or Deborah Jeremiah

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Clinical Management

Publications/Guidance
Nurse staffing and patient outcomes. There is considerable evidence of an association between nurse staffing levels and patient outcomes. The evidence has been used to support calls for mandatory nurse patient ratios but the precise significance of the relationship remains unclear. This Policy+ examines the evidence in order to establish what is known, and crucially, what is not known?

Medical students to have more 'hands on' experience. New guidance from the General Medical Council recommends that medical students gain more practical experience treating patients in hospitals before they graduate from university. The GMC believes that all medical students should be able to administer a general anaesthetic, take blood from patients and undertake other medical procedures under supervision. The guidance follows concerns that a number of skills, such as prescribing multiple drugs at the correct dosage, are being overlooked by medical schools.

Action to deliver same-sex accommodation: root cause analysis. Use of this toolkit will enable trusts to identify, understand and address issues relating to mixed sex accommodation occurrences. The purpose is to facilitate local learning and improvement and to make this sustainable.

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 by November 10, 2009.

Bevan Brittan Updates
Cases Update. Our regular update of recent cases by Georgia Ford, including extensions of time for serving Claim Forms, CFA success fees and excluding a clinician from the workplace.

Service Redeemed. We have seen a number of new cases arising from late service of Claim Forms and this summary is intended to provide some clarity into an area which has seem too much needless change in the writer's view.

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

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Commissioning

Publications/Guidance
IDeA: Commissioning for carers. This document, intended primarily for local NHS and council commissioners in England, covers the commissioning of adult services that impact adult carers, including services for the people whom carers look after.

World Class Commissioning (WCC): launch of year 2. 16 September 2009 marked the launch of the second year of WCC assurance, the national system that holds PCTs to account whilst providing support for them as they start to become world class commissioners. This guide for PCTs and SHAs explains WCC assurance in detail.

World Class Commissioning: September update. This letter gives a world class commissioning (WCC) progress report, including the launch of WCC assurance year 2, the PBC national clinical network, new support and development resources including datapacks, and an update on the programme of Integrated Care Pilots.

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

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Data Protection

Publications/Guidance
Quality accounts patient and public engagement report. This report presents findings from the public engagement on the development of Quality Accounts in the NHS which took place in August 2009. The report and recommendations are split into various themes: information needs and sources of information; content, presentation and publications; and patient and public involvement with Quality Accounts.

The right information, in the right place, at the right time: a study of how healthcare organisations manage personal data. This report looks at the policies and practices that ensure patient records are kept confidential and secure, the quality of information about patients and their care, how information is shared, and how information about patients is used to shape their care.

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

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Employment/HR

Publications/Guidance
NHS employers have produced a set of FAQ’s. NHS employers have produced a set of FAQ’s to help employers understand more about the statutory annual leave accrual by staff on long-term sick leave. The need for clarification stems from the House of Lords decision in the Stringer case which confirmed that claims for unpaid statutory annual leave can be brought under the Employment Act 1996 as a claim for unlawful deduction of wages, and which left a number of questions unanswered.

New terms and conditions for consultants. This pay circular details changes to the terms and conditions of service for consultants and corrects an earlier error in the associate specialist 2008 locum rates. Both changes come into effect from 1 September 2009.

Guidance for remuneration committees: Pay framework for very senior managers in Strategic and Special Health Authorities, Primary Care Trusts and Ambulance Trusts. This document, and the accompanying letter, introduces guidance for the use of remuneration committees when operating the pay framework for very senior managers in SHAs, PCTs, Ambulance Trusts and Special HAs, and clarifies an issue concerning performance awards for those very senior managers covered by the pay framework.

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.

Consultations
The Department of Health published its consultation, “Supporting our future NHS workforce: a consultation on the NHS bursary scheme”,  on 15 September 2009. The consultation is seeking views from students, parents, NHS and education organisations among other stakeholders on the proposed future financial support arrangements for students undertaking NHS-funded pre-registration courses. The consultation runs for 12 weeks and closes on 11 December 2009. A final recommendation is expected in early 2010.

News
Framework agreement renewal for Agency nursing staff. The existing Purchasing and Supply Agency national framework agreement for agency nursing staff ends on 30 September and a new framework agreement begins on 1 October 2009. The new agreement will run for a period of three years and use a national set of conditions of contract. However each region (SHA) will have its own set of awarded suppliers and pricing. Employers will need to examine their use of agency nursing staff and review suppliers in light of this new agreement, and consider collaborative procurement.

New timetable for implementation of Agency Workers Directive During a speech at the TUC Congress in Liverpool, Gordon Brown said that the Agency Workers Directive, which will give agency workers equal rights, will be brought in within the next few months. This is somewhat sooner than had been anticipated by most commentators and it is now expected that the Directive will hit the UK statute books in April 2010.  

Bevan Brittan Updates
When must consultations start in redundancies? Following on from the Advocate General's Opinion back in April, the ECJ has now handed down its decision in the case of Akavan Erityisalojen Keskusliitto AEK ry and Others v Fujitsu Siemens Computers Oy, clarifying a number of issues concerning the obligation to inform and consult employees about collective redundancies under the Collective Redundancies Directive (No.98/59).  Julian Hoskins reports. 

Notice pay following a constructive unfair dismissal claim. The Court of Appeal has, in the case of Stuart Peters Limited v Bell, held that the calculation of the compensatory award in a constructive dismissal claim is different to that in an actual unfair dismissal claim.  Anne Palmer explains more.

Pensions Update. In this month’s article, Christine Johnston reports on the Local Government Employer’s Organisation (the ‘LGE’) call for a return to a 2 year vesting period in the Local Government Pension Scheme and gives a summary of the Court of Appeal’s decision in the case of Booth v Oldham MBC.

News Round-up. Raj Basi reports on the latest developments in employment law including details of new guidance on the employment of children and a new Acas Code on time off for trade union duties; the launch of the consultation on the proposal to introduce gender pay reporting for private sector employees with more than 250 employees, the impending move of the East London Tribunal and a summary of the Court of Appeal’s decision in Aegon v Roberts.

Bevan Brittan ALERT! Heyday: High Court issue decision on the legality of the UK Age Regulations. The High Court has today handed down its long awaited judgment in the Heyday Case. Tim Woodward explains more. 

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

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Finance

Publications/Guidance
The current and future state of NHS finances. This survey finds that the majority of PCT finance directors say they are not well enough prepared to identify substantial efficiency savings within the NHS. It also reveals that almost half of all finance directors feel that NHS frontline staff is aware of the efficiency challenge but limited in their understanding of its impact on budgets.

Improving care, reducing cost: helping the NHS meet its 21st century challenge. This report contains analysis of how much the NHS spends on management consultancy and the types of work that management consultants do. It is based on research with members of the Management Consultancies Association and contains a series of case studies.

Consultation on the proposed framework for Quality Accounts. Quality Accounts will be legally required of all providers of NHS healthcare from June 2010, subject to the successful passage of the Health Bill. This consultation sets out the recommendations for the regulations and guidance supporting Quality Accounts in the first year, and is based on findings from a series of engagement, testing and design exercises over the past year. The consultation will close on 10 December 2009.

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. 

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Foundation Trusts

Publications/Guidance
Learning and implications from Mid Staffordshire NHS Foundation Trust. This internal audit report by KPMG considers how Monitor's methods and processes could be improved following the significant failings in quality of care at Mid Staffordshire NHS FT. The report makes 14 recommendations, each of which Monitor accept and against many of which it has already made good progress, based around two main themes: the need for better sharing of information across the healthcare system; and the need for Monitor to focus on developing an approach to assuring itself that appropriate clinical governance is in place in applicant or existing foundation trusts.
Monitor's management response to the internal audit report provides a detailed responses to the 14 key findings.

Memorandum of Understanding between the Care Quality Commission and the Independent Regulator of NHS Foundation Trusts. This memorandum sets out the framework for the working relationship between the Care Quality Commission and Monitor.

NHS foundation trusts: review of three months to 30 June 2009. This report on the performance of NHS foundation trusts and Monitor’s regulatory activity is based on quarterly submissions to Monitor by the 121 NHS foundation trusts authorised at 30 June 2009.

Measuring Monitor’s impact: economic evaluation report. This report highlights improvements in performance at NHS foundation trusts as a consequence of both Monitor’s assessment process for applicant trusts, and its risk-based approach to regulation.

Consultations
Monitor has issued its Response to the Department of Health's consultation on the de-authorisation of NHS foundation trusts, launched on 27 July 2009, that discusses proposals to introduce a power for Monitor to de-authorise foundation trusts, and for the introduction of a framework for the Secretary of State to set out his concerns where a serious failure occurs at a foundation trust. Monitor is concerned that the proposals in the consultation document are much too broadly drawn, allowing for a significant use of de-authorisation and raising the possibility of significant interference by the Secretary of State in the decision- making of Monitor, and the autonomy of NHS foundation trusts.

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

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Health and Safety

Publications/Guidance
Safety in doses: improving the use of medicines in the NHS. This review of medication incidents across the NHS in England and Wales aims to help ensure that medicines are used safely and prevent similar incidents from happening again. It identifies risks and areas for action based on a detailed analysis of 72,482 medication incidents.

NHS machines: utilisation of high-value equipment at NHS trusts. This report provides evidence that many NHS Trusts are not adequately utilising expensive treatment and diagnostic equipment. It demonstrates that there is potential to increase the efficiency of many NHS Trusts to improve service to patients and value for taxpayers.

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.

Bevan Brittan Updates
Are Coroners making patients safer? Not harming patients has been a key principle of professional medical practice for centuries.  The NHS does a great deal of good.  In England it is estimated to have contact with about a million people every 36 hours without causing harm to the vast majority.  Nevertheless, patient safety remains a concern.  So do Coroners have a role to play in making patients safer?

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

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Healthcare Associated Infection

Publications/Guidance
Working together to prevent and control infections: A study of the arrangements for infection prevention and control between hospitals and care homes. This report highlights a need for hospitals and care homes to provide information about infections to each other to make sure that people with, or recovering from, an infection are cared for properly and to reduce the chances of other people being infected.

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

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Inquests 

Bevan Brittan Updates
 Are Coroners making patients safer? Not harming patients has been a key principle of professional medical practice for centuries.  The NHS does a great deal of good.  In England it is estimated to have contact with about a million people every 36 hours without causing harm to the vast majority.  Nevertheless, patient safety remains a concern.  So do Coroners have a role to play in making patients safer?

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

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Mental Health

Publications/Guidance
Implementing recovery. This paper sets out the ten major challenges for mental health services to put recovery at the heart of their everyday practice. It calls on mental health services to make changes to the way they work with service users and how they are organised and recommends that every NHS mental health trust establishes a 'Recovery Education Unit'. The aim of these units is to train and support people with lived experience of mental illness to tell their stories and promote awareness of recovery principles.

Information sharing and mental health. This guidance sets out some of the issues relating to the exchange of information between mental health trusts and outside organisations and individuals. It sets out when, why and how information can safely be exchanged for the benefit of the individual and the public.

Multi-lingual leaflets on patients’ rights are released. Patients’ rights leaflets have been released by the NHS in more than 25 different languages. The multi-lingual leaflets are the idea of the Mental Health Act Administration Team at Northamptonshire Healthcare NHS Foundation Trust and are based on the Department of Health’s leaflets on a patient’s rights when detained under the Mental Health Act.

Autism spectrum disorders in adults living in households throughout England: Report from the adult psychiatric morbidity survey 2007. This report presents data on the presence of autism spectrum disorders, based on the data collected at phases one and two of the adult psychiatric morbidity survey 2007.

Seeing double: meeting the challenge of dual diagnosis. This report looks at the challenges posed to the NHS by people who have either developed problems with alcohol or drugs because of a pre-existing mental health condition, or have had a mental health condition caused by misusing alcohol or drugs. It addresses the way provision of services for mental health and drug and alcohol misuse have developed separately and looks at how stronger links between the two, along with better workforce development and awareness, can provide a better service and potentially save money.

National NHS patient survey programme: mental health acute inpatient service users survey 2009. This survey asked people about their experiences of acute inpatient mental health services along the pathway from admission to leaving hospital. It reveals that a proportion felt let down in some important aspects of the care they received.

PACE initiative. As part of the suicide prevention programme, PACE has been commissioned to undertake a review of the range of web-based information, support and advice services available for lesbian, gay, bisexual and transsexual (LGBT) people. This letter provides more information to SHA mental health leads about PACE and the review.

World Alzheimer report 2009. This report presents new global figures on dementia. It also offers examples of good national dementia plans and information on health service responses as well as eight recommendations that provide a global framework for action on dementia.

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.

Consultations
Pandemic influenza and the Mental Health Act 1983: consultation on proposed changes to the Mental Health Act 1983 and its associated secondary legislation. Seeks views on proposals for temporary amendments to the Mental Health Act 1983 which may be required in the event of the severe staff shortages that may be expected during an influenza pandemic. The consultation closes on 7 October 2009.

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.

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Pandemic Influenza

Publications/Guidance
Exercise Prometheus. Exercise Prometheus is a Department of Health funded exercise for the social care sector to assess and develop its resilience planning in readiness for a second wave of the pandemic swine flu. Designed as an 'off the shelf' package primarily for use by local authorities in partnership with their local providers of social care, the exercise has been developed by the Health Protection Agency from experience gained in previous pandemic influenza exercises.

Critical care strategy: managing the H1N1 flu pandemic. This strategy sets out the Department of Health's approach to managing critical care during the swine flu pandemic by increasing the number of available critical care beds and preventing people becoming seriously ill as a result of swine flu. Letters from the Chief Medical Officer and the National Director of NHS Flu Resilience have also been published.

A(H1N1) Swine Influenza: Whole-systems strategy for managing critical care needs relating to swine flu. This letter covers NHS critical care capacity and plans for increasing this to respond to increased demand during a pandemic.

Swine flu: UK planning assumptions. This document contains revised planning assumptions in relation to the current A(H1N1) Swine Flu pandemic. The assumptions are intended to provide a common agreed basis for planning across all public and private sector organisations. These revised assumptions are appropriate for use until the end of the 2009/10 "seasonal flu" season - i.e. until Mid-May 2010.

Pandemic influenza: paediatric clinical pathways; information for health care professionals working in hospitals. This guidance provides paediatric information for hospital-based clinical staff who may need to care for children acutely unwell with influenza during a pandemic.

Pandemic influenza toolkit for NHS Ambulance Services in England. This toolkit is part of the Department of Health’s programme for improving and enhancing the preparedness within NHS ambulance services for managing pandemic influenza. The aim is to support ambulance trusts in the delivery of an operational response. The body of the toolkit provides a summary statement of individual topics and signposts to further information, websites and material published by the department.

Managing influenza-like illness (ILI) in nursing and residential homes during the current influenza pandemic (WHO phase 6). This guidance aims to provide advice on the generic management of cases or outbreaks of flu-like illness in nursing and residential homes, and provides specific guidance appropriate to pandemic (H1N1) 2009 influenza.

H1N1 pandemic research, National Institute for Health Clinical Research Networks and National Institute for Health Research Support Services. This letter from Director General of Research and Development Dame Sally Davies describes current research effort related to the H1N1 epidemic and the related work of the National Institute for Health clinical research networks.

A (H1N1) swine influenza: vaccination delivery. Three dear colleague letters have been published on the delivery of the swine flu vaccination programme: one from Sir Liam Donaldson, Chief Medical Officer, another from Sir Bruce Keogh and another from Christine Beasley, Chief Nursing Officer and Karen Middleton, Chief Health Professions Officer to Directors of Nursing and SHA AHP leads.

Authorisation of antiviral medicines: Guidance on the use of FP10SS forms and antiviral authorisation vouchers during the H1N1 (swine flu) pandemic in England. This document gives information on when Antiviral Authorisation Vouchers can be used, how the forms need to be completed, how they can be accessed and re-ordered and other security aspects around handling Antiviral Authorisation Vouchers.

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. 

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Primary Care Trust

Publications/Guidance
Your health, your way: A guide to long-term conditions and self-care - Communications toolkit. This toolkit provides all the assets and artwork to enable primary care trusts to implement a self-care communications campaign at a local level.

Guidelines for the delivery of a domiciliary oral healthcare service. The purpose of this is to alert PCTs and service providers to the need for maintaining and increasing the availability of Domiciliary Oral Healthcare Services (DOHCS); to provide guidance for the commissioning of high quality DOHCS and to establish standards for the delivery of high quality DOHCS.

The NHS (Pharmaceutical Services) Regulations: information for Primary Care Trusts - revised September 2009. This guidance has been produced to assist PCTs in the assessment and determination of applications to provide NHS pharmaceutical services. It incorporates reforms effective from 1 April 2005 to the regulatory system and amendments to the regulations since.

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.

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

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Prison Health

News
Double murderer Dennis Harland Roberts wins cosmetic treatment case. The High Court has ruled that Dennis Harland Roberts, a double murderer serving a life sentence, can undergo cosmetic surgery on the NHS to remove a large facial birthmark. The case, which could prompt other prisoners to seek treatments they might have been denied, concerns a policy which restricts prisoners' access to cosmetic and other treatments that are not considered to be urgent. The Government's full policy on the issue had not been disclosed and Michael Supperstone, QC, a deputy High Court judge, said this was unlawful and contrary to good administration.

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

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General

Publications/Guidance
Taskforce on the health aspects of violence against women and girls. Letter from Claire Phillips, Deputy Director, Cross Government Programmes, Stakeholder and Partner Relationships, seeking views from a wide range of stakeholders to the Department of Health's Taskforce on Violence Against Women and Girls.

Putting patients at the heart of care. This document sets out the vision for patient and public engagement. It explains what it means and the role it can play in driving up the efficiency, quality and productivity of services.
The DH has also published Helping the NHS put patients at the heart of care, providing information on the DH support programme to help services engage patients and the public.

Confidentiality. The GMC has published new guidance for doctors on confidentiality that sets out the principles of confidentiality and respect for patients' privacy that doctors are expected to understand and follow; takes account of the relevant legal and ethical considerations involved in helping doctors to make decisions that respect patients’ privacy, autonomy and choices and that also benefit the wider community of patients and the public; takes account of changes in the law; and guidance from other sources on confidentiality in the four UK countries is accompanied by seven pieces of supplementary guidance which explain how the principles in the core guidance apply in a range of situations doctors often encounter or find hard to deal with, including reporting concerns about patients to the DVLA, reporting gunshot and knife wounds and disclosing information about serious communicable diseases. The guidance will come into effect on 12 October 2009.

Hospital pharmacy practice in the UK and the Responsible Pharmacist requirements. This guidance from the Royal Pharmaceutical Society of Great Britain (RPSGB) and Pharmaceutical Society of Northern Ireland (PSNI) outlines hospital activities that can only take place from a pharmacy premises registered with the RPSGB or the PSNI, therefore defining where a responsible pharmacist is required to be in charge of the pharmacy. Hospital activities that require an appropriate licence (for example a wholesale dealer’s licence or manufacturing licence) from the Medicines and Healthcare products Regulatory Agency (MHRA) are also identified.

Guidance on direct payments for community care, services for carers and children's services: England 2009. This updated guidance assists local authorities in making direct payments, and provides guidance on how they might manage and administer direct payments. It replaces the 2003 direct payments guidance. The guidance has been updated to reflect recent legislative changes that extend direct payments to previously excluded groups.

The use of 084 telephone numbers in the NHS: Department of Health response to consultation. This is the Government's response to a consultation on the future use of 084 numbers in the NHS. It states that the use of phone numbers that charge the public or patients a premium rate to contact the NHS is to be banned in England. This will allow a marketplace to evolve where 084 numbers compete alongside 01, 02 and 03 numbers, but where patients will pay no more than the cost of a local call. The ban means that GPs and other NHS organisations remain free to use 084 numbers, providing patients are not charged more than a local rate number. The ban will be enforced through proposed changes to the GP contract (in consultation with the BMA's GP Committee), and the issuing of Directions to NHS PCTs and Trusts. These changes will be put in place as soon as practicable.

Access to healthcare abroad. Informs tells citizens about how they can get healthcare in other countries in the European Economic Area.

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.

Consultations
Health and public sector professionals to help improve health services for victims of domestic violence. A Department of Health consultation invites comments on how the NHS can improve its services for women and girls who have been victims of violence and sexual assault. Comments received will contribute to a cross-Government strategy, to be published later in 2009, which aims to ensure that all services work closely together to reduce violence against women and girls and provide the best possible support to victims. Comments by October 14, 2009.

A public consultation on the DPP's interim policy for prosecutors on assisted suicide. New guidance from Keir Starmer, QC, the Director of Public Prosecutions, has been issued to clarify the law on assisted suicide in England and Wales. The guidance, issued after the Law Lords backed Debbie Purdy, who has multiple sclerosis, in her call for a policy statement on whether people who help someone commit suicide should be prosecuted, makes it possible for relatives to help loved ones to die without fear of prosecution. Each case will be considered on its own merits, however, and immunity against prosecution will not be given in certain circumstances. The medical profession will be bound by the guidelines, which were put out to public consultation on September 23, 2009 and will have immediate effect. The Law Society believes that the Government should still legislate and "right to life" groups said that Mr Starmer had exceeded his authority.

National Institute for Health and Clinical Excellence (NICE) consultation on the Quality and Outcomes Framework. NICE have opened the first consultation period for the QOF. As part of NICE's new role in the QOF, stakeholders will now be able to add their input to the prioritisation of recommendations for development for the 2012/13 framework and also comment on existing indicators via the NICE website.

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.

News
UK Supreme Court delivered on time and on budget. The Lord Chancellor and Secretary of State for Justice Jack Straw has announced the successful delivery of the new UK Supreme Court. The court will open from 1 October 2009 and will be the final court of appeal for all civil cases in the UK, all criminal cases in England, Wales and Northern Ireland, and will also assume the devolution jurisdiction of the Judicial Committee of the Privy Council.

Bevan Brittan Updates
Practical tips on effective debriefing. If an unsuccessful bidder requests a debriefing,contracting authorities are under a duty to give reasons for their decision.

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

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