Health & Social Care Update

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.

23/07/2009

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   Governance
  Children   Health and Safety
  Clinical Management   Healthcare Associated Infection
  Clinical Research   Inquests
  Commissioning   Mental Health
  Complaints   Pandemic Influenza
  Data Protection   Primary Care Trust
  Employment/HR   Prison Health
  Finance   Regulation
  Foundation Trusts   General
  Freedom of Information

 

Care

Publications/Guidance
The case for change: why England needs a new care and support system - engagement findings. This document sets out the findings from the engagement process held between May and November 2008, which engaged with the public and key stakeholders about how they existing system can meet the challenges of the future.

Safeguarding adults: report on the consultation on the review of 'No Secrets'. More than 12,000 people participated in this consultation and their responses are analysed in this report. The original consultation ran between October 2008 and January 2009.

Revised National Framework for NHS Continuing Healthcare and NHS-funded Nursing Care. This framework clarifies and supports consistency in the determination of eligibility for NHS continuing healthcare and NHS-funded nursing care. NHS bodies and local authorities are encouraged to work together to prepare for implementation in October 2009

Planning for pandemic influenza in social care: Induction presentation. This presentation is intended as a training tool for social care managers and trainers, and is aimed at anyone working in social care.

Personalisation briefing for home care providers. This briefing outlines the principles of personalisation and the implications for home care providers. Issues such as capacity, recruitment and retention are discussed, as are the potential risks.

End of Life Care Strategy: quality markers and measures for end of life care. The End of Life Care Strategy was published in July 2008 and included a commitment to publish quality markers for end of life care. During its development, the SHA End of Life Care Pathway Chairs identified that commissioners and providers needed support in delivering improvements in care. The resultant quality markers contained in this document are intended to meet this need.

End of life care strategy: First annual report. This report sets out the progress made in the year since the publication of the DH's end of life care strategy.

Consultations
Prioritising need in the context of Putting People First: a whole system approach to eligibility for social care. Seeks views on the revision of the statutory guidance providing local authorities with a framework to determine individual eligibility for social care. The draft revised guidance aims to reset the eligibility criteria framework within the policy context of personalisation and prevention set out in the cross-sector agreement for the transformation of adult social care Putting People First. The consultation closes on 6 October 2009.

Shaping the future of care together. This Green Paper sets out a vision for a new care and support system. It highlights the challenges faced by the current system and the need for radical reform to develop a care system that is fair, simple and affordable for everyone. It puts forward three options for funding such a National Care Service:
 partnership: the responsibility for paying for care would be shared between the Government and the person who has care needs;
 insurance: as well as receiving between a third and a quarter of the cost of care, it would be easier for people to take out insurance to cover care costs. It is estimated that the cost of insurance could be around £20,000 to £25,000; or
 comprehensive: everyone who can afford it would pay into a state insurance scheme meaning everyone who needs care will receive it free. It is estimated that the cost of being in the system could be between £17,000 and £20,000.
Comments are required by 13 November 2009.

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

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Children

Publications/Guidance
When to suspect child maltreatment. NICE has issued guidance to help healthcare professionals to identify children who may have been maltreated. The guidance provides a summary of alerting features that should prompt a healthcare professional to consider, suspect or exclude child maltreatment. Child maltreatment includes neglect, physical, sexual and emotional abuse, and fabricated or induced illness.

DCSF: Effectiveness of the new Local Safeguarding Children Boards in England - interim report. Report from research into how LSCBs manage their safeguarding role and if the new systems and arrangements are ‘fit for purpose’ and are influencing and improving frontline practice. The small scale survey of 20 children’s centres in six local authorities found that over half of the centres were providing effective integration of services in supporting children and their parents making life changing differences. Leadership and management were rated good and outstanding in 15 of the centres visited.

Ofsted: The impact of integrated services on children and their families in Sure Start children’s centres. This report evaluates the impact of integrated services on children, parents and families in 20 children’s centres. It finds that the effective integration of services is having a positive impact in terms of support for children and parents in over half of the centres visited. Three centres were judged as making an outstanding difference. Challenges remain with onward links with primary schools, in reaching the most vulnerable families and in developing data on outcomes for parents and children. The least effective partnership working seen was between the children’s centres and Jobcentre Plus.

DCSF: Safeguarding disabled children - practice guidance. Advises local organisations on how to best safeguard and promote the welfare of disabled children. The practice guidance is an update following the publication of ‘Working together to Safeguard Children’, which was issued in 2006. It is aimed at Local Safeguarding Children Board (LSCB) partners, practitioners and other professionals working with disabled children and young people and their families.

Safeguarding children and the Care Quality Commission review. This letter sets out expectations for further improvements required by the Care Quality Commission's review on the arrangements in the NHS for safeguarding children.

Safeguarding children: a review of arrangements in the NHS for safeguarding children. This review was carried out at the request of the Secretary of State for Health, following the legal case relating to the death of Baby P. The review looks specifically at board assurance around child protection systems, including governance arrangements; around training and staffing; and around arrangements for health organisations to work in partnership with others to safeguard children. The findings indicate that most trusts have the right people and systems in place for safeguarding children.

Preventable child deaths in England: Year ending 31 March 2009. This statistical release presents data collected from local safeguarding children boards in England.

The Home Office Forced Marriage Unit has published a revised set of multi-agency practice guidelines for frontline professionals (such as teachers, police officers, social and health care professionals, housing officers) to help them to work more closely together and to better identify and protect children and adults at risk of forced marriage. The revised guidelines replace the existing individual guidelines which were tailored for specific professionals and now brings these together into one single document.

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
Addendum to the NHSLA risk management standards for Independent Sector Providers of NHS care. Explains how ISPs of NHS care can choose to be assessed and provides supplementary details about the assessment process is now available. The NHSLA wrote to all ISPs of NHS care in June 2009 to provide details of the assessment process.

A year of progress towards High Quality Care for All. This report from Lord Darzi examines the progress that has been made since High Quality Care for All was published a year ago. Across each dimension of quality (patient experience, patient safety and clinical effectiveness) Lord Darzi has found that there has been real progress with patients already seeing the difference. Major improvements highlighted in the report include the opening of 50 new GP led Health Centres, the introduction of personal care plans for 9.3m patients with long term conditions, and the growth in keyhole surgery. The focus on quality has moved up the agenda for staff and organisations, supported by the promotion of innovation through the introduction of tools and funds such as NHS Evidence, the Innovation Fund and the Challenge Prizes. The report also outlines plans to drive up the quality agenda even further and free up clinicians time to do this.

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

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Clinical Research

Publications/Guidance
Requirements to support research in the NHS. This letter from Director General of Research and Development Professor, Dame Sally C Davies, and Director General of NHS Finance, Performance and Operation, David Flory, draws attention to recent policy statements and operational requirements regarding research in the NHS.

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

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Commissioning

Publications/Guidance
PBC two years on publication. A survey of GPs and practice managers by The King's Fund and NHS Alliance has found continuing commitment to practice-based commissioning and optimism about its potential to make a difference. However, real clinician engagement will be key to its successful development.

Signs for improvement: commissioning interventions to reduce alcohol-related harm. This guidance is designed to direct to the resources and guidance which will assist them in commissioning interventions to reduce alcohol-related harm in their local community. It offers ways to improve commissioning, looking at each World Class Commissioning competency and at all stages in the commissioning cycle.

Working together to provide age-appropriate environments and services for mental health patients aged under 18. This briefing has been written to support commissioners of both adult mental health services and child and adolescent mental health services to prepare to meet the requirements of a new duty within the Mental Health Act 2007, amending the 1983 Act, to admit and treat patients aged under 18 into an environment in hospital which is suitable having regard to their age. The Government has committed to commencing this duty in April 2010, with the purpose of preventing the inappropriate admission of children and young people to adult psychiatric wards.

Recognising complexity: commissioning guidance for personality disorder services. This guidance is aimed at commissioners in the NHS, criminal justice system, local authorities and others and provides information and suggestions on best practice when considering services and systems for people with personality disorders.

A new national template for commissioning NHS Health Checks from community pharmacy. The NHS Health Check Service, a universal systematic, integrated check for all people between the ages of 40 and 74 that is delivered through a variety of providers including community pharmacies, has been rolling out since April 2009. The Chief Pharmaceutical Officer for England, Dr Keith Ridge, has written to PCT Chief Pharmacists to promote a new model template designed to help PCTs who may wish to commission NHS Health Checks from community pharmacy.

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

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Complaints

Publications/Guidance
Fitness to practise annual report: 1 April 2008 to 31 March 2009. Figures presented in a report to the Nursing and Midwifery Council (NMC) show an increase in the number of complaints about nurses and midwives. There was an increase of over 18% in the number of complaints assessed as suitable for for further investigation, representing the highest number of allegations received by the regulator since 2005. The largest number of complaints came from employers of nurses and midwives followed by those from the police. Complaints from members of the public have also increased. Many complaints directly involve patients, most commonly concerning incidents of physical or verbal abuse and failure to communicate and respect the dignity of patients.

Legislation
Local Authority Social Services and National Health Service Complaints (England) (Amendment) Regulations 2009 (SI 2009/1768). These regulations, which come into force on 1September 2009, amend SI 2009/309 that sets out the procedure for the handling of complaints by local authorities in respect of complaints about adult social care, and by NHS bodies, primary care providers and independent providers in respect of provision of NHS care. The main alteration corrects a drafting error in the principal regulations which meant that the scope of complaints that local authorities were required to consider under the new complaints system would be inadvertently different from the scope of complaints under the 2006 regulations.

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

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Data Protection

Publications/Guidance
Record keeping: a letter to doctors. Dear Colleague letter from Chief Medical Officer Sir Liam Donaldson to doctors and consultants on the importance of maintaining separate clinical and research records. It also includes information about acting as an expert witness.

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
Engaging for success: enhancing performance through employee engagement. The Government has been presented with the recommendations for promoting employee engagement in the UK from the independent MacLeod Review, led by the Department for Business, Innovation and Skills. The review uses examples from the NHS in its recommendations for effective employee engagement to help inspire good practice and promote debate among other organisations.

European Working Time Directive. Letter from David Nicholson to Trust Boards and Trust Chief Executives about the commitment to support the NHS in achieving compliance with the European working Time Directive (EWTD) by 1 August 2009.

Managing during a recession: ACAS/CIPD guidance. The Chartered Institute of Personnel and Development (CIPD) have published guidance for managing your workforce in a recession. The guidance encourages innovation as a means of avoiding job cuts and highlights the importance of effective people management for maintaining employee engagement, wellbeing and productivity during difficult times. 

Transitional immigration arrangements for 2009 medical recruitment. Employers can now access full details of the agreed transitional arrangements for trainees who hold a postgraduate doctors and dentists visa and who will be moving into speciality training or other medical posts from August 2009.

Revalidation - medical appraisal toolkit published. The Revalidation Support Team (RST has published a document outlining good practice in medical appraisal, which contains a useful toolkit that supports employers to assess their readiness for revalidation.

NHS mutual: engaging staff and aligning incentives to achieve higher levels of performance. This report examines the relevance and applicability of employee ownership models to the NHS. The international evidence gathered for the report suggests that employee ownership - when combined with opportunities for staff to participate in the workplace - can deliver a range of benefits. These include improved organisational productivity and performance, reduced staff turnout and sickness absence, greater innovation and higher levels of staff motivation and commitment. 

Cases
In the recent case of Hovell v Ashford and St Peter’s Hospital NHS Trust the Court of Appeal held that a tribunal need not obtain an independent expert's report before it can find equal value between an equal pay claimant and a comparator ranked higher in a job evaluation study. However the Court also made it clear that the fact that there is only a small difference in points awarded to each person under a job evaluation study (JES) will not, in and of itself, be sufficient to establish the jobs are of equal value. In order to rely on the JES alone to demonstrate that the work was of equal value, in a situation where the claimant has scored fewer points than her comparator, she  must also, as a minimum, set out the difference in points 'in the context of the particular JES and explain why the difference should be ignored.'   In this case the Claimant was employed as a social services administrator. Following Agenda for Change the Claimant was placed on Band 4 which covers those who had obtained between 271 and 325 points in the JES. The Claimant scored 274 – her three male named comparators scored 296, 298 and 305 respectively. The JES was implemented from 1 October 2004 from which time the Claimant received the same pay as her comparators. Having achieved that equality the Claimant then sought to establish that she had been entitled to equal pay in the six year period prior to the implementation of the scheme under section 1(2) (c) of the Equal Pay Act 1970 (asserting her work had been of equal value to that of her comparators). The employment tribunal judge ordered that an independent expert should be appointed to prepare a report on the question of equal value, however the Claimant then made an application to withdraw that requirement as, she asserted, the fact that her job had been rated as equivalent to that of the male comparators necessarily determined that the jobs were of equal value for the purposes of section 1(2) (c).  In the alternative the Claimant argued that the difference in scores was so small that the only proper conclusion was that the jobs were of equal value. Both the Employment Tribunal Judge and the Employment Appeal Tribunal rejected the Claimant’s submissions which were then placed before the Court of Appeal, leading to the finding as outlined above.

Consultations
Equality Bill: Making it work - Ending age discrimination in services and public functions - a consultation. The Government Equalities Office seeks views on age discrimination proposals, including proposals concerning health and social care, and financial services providers. Comments must be submitted by 30 September 2009.

Improving Working Lives framework launched. The NHS Staff Council, working in partnership, has produced Improving Working Lives in the NHS - a framework. The framework maintains the principles of the original IWL standards and takes into account recent changes in the NHS and employment practices. The framework is a practical tool providing a reference point for healthcare organisations and examples of good practice.  

Legislation
GP registrars - 2009 pay and contractual issues. The DoH direction to health authorities to amend GP registrar pay rates came into effect on 8 July 2009. The Direction included aligning arrangements for pay and maternity leave with those of medical trainees in hospital posts and backdates the revised pay rates to 1 April 2009. 

Working time directive derogation update. The limit on the average working week for junior doctors was due to fall to 48 hours (from 56) on 1 August 2009. However in light of fears around patient safety and quality of training the Government is extending a limited derogation, imposing a 52 hour limit,  for certain junior doctors until 31 July 2011. The Working time (Amendment) Regulations 2009  have been laid before Parliament and contain a detailed schedule listing the areas and specialisms covered by the derogation. For those who do not fall within the derogation the deadline of 1 August for the reduction in hours will still need to be met.

News
Recruitment and retention payment for pharmacists rejected. The Government has rejected a national recruitment and retention payment for junior pharmacists, and is advocating the use of local recruitment and retention premia, where needed, alongside specific targeted initiatives at the local level. The rejection is supported by NHS Employers.

Foundation Programme tier 4 sponsorship. The UK Foundation Programme Office (UKFPO) has been approved as the tier 4 sponsor for non-EEA graduates of UK medical schools who require a tier 4 visa and are starting a Foundation Programme post in August 2009. Transitional arrangements are in place so that graduates can start their Foundation Programme posts in August and apply for a tier 4 visa before the end of October 2009.

Bevan Brittan Updates
Employment Alert: Statutory Disciplinary and Grievance Procedures – All over on 4 July? The statutory disciplinary and grievances procedures refused to slip quietly into the night, following the introduction of the Employment Act 2008 and the new Acas Code of Practice. However now that the trigger date of 4 July has past does this mean the SDRP’s are a thing of the past… unfortunately not. Tim Woodward explains more.

Employment Alert: Court of Appeal hand down judgment in Gutridge v Sodexo – 14 July 2009. The Court of Appeal has handed down its decision in the case of Gutridge & Others v Sodexo & Others which deals with equal pay rights in the event of a TUPE transfer. Sarah Lamont explains more.
 
Stringer Q & A – more questions than answers? As we reported last month the House of Lords has now issued its much awaited judgement in the case of Stringer and Others v Her Majesty’s Revenue and Custom. Far from providing a final and definitive stance on the much debated issue of the entitlement to annual leave during sick leave, the decision seems to have created more questions than answers. Sara Woffenden deals with some of the more frequently asked questions that have arisen from the judgment.

A ‘likely’ story … Following on from our Employment Eye article back in February this year, the House of Lords have now had an opportunity to determine the true meaning of the word ‘likely’ in a disability discrimination context. In a landmark ruling in the case of SCA Packaging Limited v Boyle their Lordships have extended protection against disability discrimination to employees with a physical or mental condition which remains controlled and has little impact on their day to day lives. John Moore explains more.

NHS Pension Choice Exercise.
There has been much publicity in the press recently in relation to “Your NHS Pension Choice” which is an exercise designed to give all eligible members of the NHS Pension Scheme a one-off option to transfer all of their membership from the 1995 Section into the 2008 Section if they wish. Given the logistical size of the exercise it is scheduled to last for three years, Christine Johnston explains more.

News Round-up. Marie-Claire Boyle reports on the latest developments in employment law including a number of new Guidance documents; an update on the progress of the Equality Bill through Parliament, a summary of CBI’s request to introduce an alternative to redundancy scheme and news of a limited derogation for junior doctors from 1 August 2009.

Bevan Brittan Training

Employment Absence: Employment Absence: How to manage risks and avoid personal injury action..
10.00am – 12.30pm. Registration from 9.30am. Bristol - 15 September, Birmingham - 16 September, London - 18 September.  We all know that workplace absences affect productivity and profits. Repeated occurrences can lower morale and motivation in both the absent and those remaining. In a struggling economy, anxiety and stress related problems are on the increase and a failure to deal with the early warning signs could store up problems for the future. Employees can become more litigious in a difficult economy. While sickness absence is not a new occurrence, employees are increasingly aware of their rights, both in the Employment Tribunal and also in relation to personal injury actions. This workshop based session will look at the key steps managing absence in the workplace with a particular focus on stress problems. Members of Bevan Brittan’s Personal Injury team will also provide guidance on how to deal with a personal injury claims; together with a review of the practical steps employers can take to prevent further claims being brought.

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


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Finance

Publications/Guidance
King's Fund analysis of the Green Paper on social care. Discusses whether the Green Paper follows the right principles, offers the right options and maps out the right way forward for social care? Includes an analysis of the government's proposals for reforming the funding and delivery of social care.

How cold will it be? What are the prospects for NHS funding in the current financial climate? A new report from The King's Fund and the Institute for Fiscal Studies sets out possible future funding scenarios and their consequences.

International Financial Reporting Standards subsidies for NHS Bodies. In February 2009, in recognition of the financial pressures that public bodies are facing in the current economic climate, the Audit Commission decided that it should subsidise the 'one-off' element of the cost of transition to international financial reporting standards for NHS bodies and probation boards and trusts from 2009-10. This gives more information about subsidies for NHS bodies.

A guide to finance for hospital doctors. The Audit Commission and the Academy of Medical Royal Colleges have jointly published a short, practical manual that aims to help hospital doctors to get to grips with the way the money works in the health service. By understanding how the money flows and some of the principles of financial management in the NHS, hospital doctors will be well equipped to deliver better patient care. The guide is aimed at medical students and doctors in the early stages of their training. Chapters in the guide explain how the money works in the NHS; trust finance regimes; managing a budget; and making the best of the money available. It contains case studies from Gloucestershire, London, Bolton and Plymouth that illustrate how better understanding of the money can help transform services. It also contains a useful glossary explaining the language of NHS finance.

Understanding personal health budgets. In January 2009 the DH published Personal Health Budgets: First Steps, which set out the principles of personal health budgets and invited expressions of interest in the pilot programme. This leaflet is designed to give organisations involved in developing personal health budgets consistent, accessible information to give to people. It introduces the idea of a personal health budget and provides details of where to obtain further information.

Health profiles 2009. Health profiles provides a snapshot of health for each local council in England using key health indicators, enabling comparison locally, regionally and over time. They are designed to help local councils and the NHS decide where to target resources and tackle health inequalities in their local area. The 2009 version has now been published.

The Government's response to the Health Select Committee report on top-up fees. Professor Mike Richards, the National Clinical Director for Cancer, was asked in June 2008 to review the policy for patients who wished to buy additional drugs privately. Following his report, 'Improving access to medicines for NHS patients', the DH instructed NHS trusts to cease immediately the practice of withdrawing funding for NHS patients who had purchased additional treatment. However, the Health Select Committee in May 2009 raised concerns about the risks of potential disadvantages to NHS patients including the formation of a "two-tier" system. This Command Paper sets out the Government's response to the Committee's conclusions and recommendations. The Government welcomes the Committee's conclusion that Professor Richards' recommendations on additional private care are the best option for the NHS.

Learning disabilities directed enhanced services (DES) - worked examples. This paper provides four examples using different possible scenarios of how payments for the learning disabilities directed enhanced service should be calculated.

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
Progress report on Mid Staffordshire NHS Foundation Trust. This report covers progress on mortality rates in emergency care at Mid Staffordshire NHS FT. The CQC will conduct a second, detailed review in a further three months' time which will include unannounced inspections where it will expect to see substantial progress on key priority areas. In one year's time it will conduct a full review against the action plan and report on all areas. Part 2 and Part 3 of our report will be available on our website in October 2009 and May 2010.
In light of the failings identified at Mid Staffordshire NHS FT, the Health Secretary Andy Burnham has announced a package of measures to tackle exceptional failures in Foundation Trusts:
 a further, independent, inquiry chaired by Robert Francis QC to hear evidence from patients and families, building on the reports to date and the Independent Clinical Reviews underway, and identify lessons for the future. See also the full Terms of Reference;
 working closely with Monitor to appoint a new Chair, Sir Stephen Moss, and new Chief Executive, Antony Sumara, who have the skills and experience to transform services at Stafford Hospital as a matter of urgency;
 asking Dr David Colin-Thomé to support and advise the PCT to ensure they are implementing all the recommendations from his report and working with the local community to shape the future of the Trust; and
 consulting on changes that will enable Monitor to ‘de-authorise’ a foundation trust where the trust is failing to meet the high standards rightly expected of an organisation afforded FT status. A consultation on the proposed amendments to foundation trust legislation will be published shortly.

NHS foundation trusts: consolidated accounts 2008-09. Monitor have reported that the consolidated accounts for 115 NHS foundation trusts for 2008-09 reveals a sector in good overall financial health, but with first signs of likely financial challenges ahead.

Monitor's annual report and accounts. This report describes how the regulator is responding to the challenges facing the NHS and urges all remaining NHS trusts not to lose focus in preparing their organisations for foundation trust status. It also sets out significant achievements and developments during the past 12 months in the core areas of Monitor's work: authorising, regulating and developing NHS foundation trusts.

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

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Freedom of Information

Publications/Guidance
Freedom of Information Act 2000: Designation of additional public authorities - Response to Consultation.  In its response to the consultation on extending the Freedom of Information Act, the Government announces a further consultation will be conducted on whether to include within the scope of the Act: Academies; the Association of Chief Police Officers; the Financial Ombudsman Service; and the Universities and Colleges Admission Service. A new Code of Practice on managing digital and other records was also announced on July 16, 2009 by Minister of State at the Ministry of Justice, Michael Wills, to ensure key records remain available to public bodies.

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

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Governance

Publications/Guidance
National Benchmarker re-released with HRG4 data. The Audit Commission, supported by the NHS Information Centre, has released a new set of benchmarking data to assist the NHS with the introduction of healthcare resource group (HRG) 4. As well as updating the existing indicators, some new HRG4-specific indicators have been developed. The data is for use by PCTs, NHS trusts, hospital departments and individual clinicians to compare acute hospital activity data, clinical coding and payment by results related data with other organisations to flag up questions for concern.

If you wish to discuss any of the items raised in this section please contact Tracey Lucas, Vincent Buscemi or Deborah Jeremiah

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Health and Safety

Publications/Guidance
Joint statement by the four UK Health Departments on the regulation of clinical physiologists. This statement highlights the commitment of the four Health Departments to the regulation of healthcare scientists. Five groups of healthcare scientists (clinical perfusionists, clinical technologists, clinical photographers, maxillofacial prosthetic technologists and clinical physiologists) have been recommended by the Health Professions Council to the SoS for statutory regulation. The four Health Departments will work with key stakeholders to achieve statutory regulation for these five groups of healthcare scientists for the purpose of improving public protection and patient safety.

House of Commons Health Committee: Patient safety. This report scrutinises the effectiveness of the Government's Patient Safety policy which focuses on the creation of a unified national mechanism for reporting and analysing incidents, underpinned by a new culture of openness in the NHS under which staff would feel able to report and discuss incidents without fearing unfair blame. Systems for reporting, and learning from, incidents, were established, centred on the National Reporting and Learning System (NRLS) and the National Patient Safety Agency (NPSA). The report considers that, for all the policy innovations of the past decade, there has been insufficient progress in making services safer. There appears to be a tacit admission that not all services are safe enough yet and this is strengthened by the recent cases of disastrously unsafe care that have come to light in a small number of Trusts, such as Mid-Staffordshire NHS FT. The Committee concludes that there are significant deficiencies in current policy and it recommends several changes that need to be made in order for there to be further progress in tackling unsafe care.

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
NHS foundation trusts: review of twelve months to 31 March 2009. Results published by Monitor indicate that foundation trusts are continuing, in most cases, to meet national standards and targets in key areas such as combating healthcare associated infections. The report reviews data on key service performance issues and includes the end of year financial position for the 115 NHS foundation trusts authorised at 31 March 2009.

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

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Inquests

Publications/Guidance
Summary of reports under Rule 43 of the Coroners Rules. A Ministry of Justice report gives details of coroners' reports and responses received from organisations involved in deaths who had been asked to take preventative future action. The report, which covers the period July 2008 to March 2009, aims to improve public health and safety by identifying action which the coroner considers should be taken to prevent future deaths.

News
Lords reject assisted dying law. A move to amend the Coroners and Justice Bill make it legal to help a terminally ill person to die has been defeated in the House of Lords. The change would have allowed loved ones to accompany the dying abroad. 

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
Investigation report into West London Mental Health NHS Trust. This is the report of a CQC investigation that looked at high-secure, inpatient services at Broadmoor Hospital as well as community and other inpatient services in Hounslow, Ealing, Hammersmith and Fulham. The report highlights serious concerns relating to: failure to properly investigate suicides; failure to learn from serious incidents; poor environment and high bed occupancy; overcrowding; poor physical healthcare; not enough staff; and lack of staff training.

Coercion and consent: monitoring the Mental Health Act 2007-2009.
The Mental Health Act Commission have published a final report on the Mental Health Act and the care provided to people detained under the Act. The report claims that while there were good examples of people receiving good care during their visits to services there were variation across services. The Care Quality Commission (CQC) have published a response to this report.

The Bradley Report and the Government’s response: the implications for mental health services for offenders. This briefing paper echoes Lord Bradley’s call for nationwide coverage of specialist teams to divert people with mental health problems to treatment and support at any stage of the criminal justice system. It calls for Criminal Justice Mental Health teams to become gateways to mainstream mental health services in the community.

Living Well with Dementia: A national dementia strategy implementation plan. This plan describes the arrangements for national and regional support and programmes that have been put in place to support delivery of the national dementia strategy.

Mental Health Act Commission Report. This report provides an overview of the care provided to people detained under the Mental Health Act.

A future vision for mental health. This report sets out a new vision for the future of mental health and well-being in England. It outlines the priorities that The Future Vision Coalition believe should underpin mental health policy for the next decade. The National Service Framework for Mental Health comes to an end later this year and the Department of Health is working towards a replacement through its New Horizons programme. This report is the result of the Future Vision Coalition's work on what the next stage of mental health policy should be. It sets out four policy principles and a range of actions for the short-term (a year), medium-term (5 years) and long-term (10 years).

Working together to provide age-appropriate environments and services for mental health patients aged under 18. This briefing has been written to support commissioners of both adult mental health services and child and adolescent mental health services to prepare to meet the requirements of a new duty within the Mental Health Act 2007, amending the 1983 Act, to admit and treat patients aged under 18 into an environment in hospital which is suitable having regard to their age. The Government has committed to commencing this duty in April 2010, with the purpose of preventing the inappropriate admission of children and young people to adult psychiatric wards.

Recognising complexity: commissioning guidance for personality disorder services. This guidance is aimed at commissioners in the NHS, criminal justice system, local authorities and others and provides information and suggestions on best practice when considering services and systems for people with personality disorders.

Moving on up. This report from the Mental Health Foundation reveals the barriers that are preventing patients with mild or moderate depression from accessing exercise on prescription. They include funding constraints within local government and PCTs, and that many GPs aren't aware that exercise schemes are available in their area.

Cases
W Primary Care Trust (1) TB (An adult by her litigation friend the Official Solicitor) (2) V (3) S Metropolitan Borough Council (4) C & W Partnership NHS Foundation Trust (5) W Metropolitan Borough Council. [2009] EWHC 1737 (Fam)  The court determined that a woman suffering from a brain injury with an associated psychiatric disorder was eligible to be deprived of her liberty at a specialist care home. The conditions for ineligibility in the Mental Capacity Act 2005 Sch.1A para.5 were not met, since she was not a "mental health patient" within Sch.1A para.16 because the care home did not fall within the definition of a "health service hospital" in the relevant provisions of the Mental Health Act 1983.

R (P) v Secretary of State for Justice [2009] EWCA Civ 701. Where there was no immediate risk to an offender's life from his regular self-harming and the Secretary of State had relied on medical advice of an appropriately qualified doctor that he did not require hospital treatment, there had been no breach of the European Convention on Human Rights 1950 art.2 or art.3 caused by a delay in transferring him from a young offenders' institution to a psychiatric hospital, and no duty to undertake an inquiry into his detention arose.

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
Planning for pandemic influenza in social care: Induction presentation. This presentation is intended as a training tool for social care managers and trainers, and is aimed at anyone working in social care.

Flu Response Centres - secondment arrangement agreement. The Health Protection Agency (HPA) has put in place secondment arrangements for the staffing of Flu Response Centres, which are being set up throughout the UK to respond to the potential swine flu pandemic.  NHS Employers has agreed with the HPA to make secondment agreement documents widely available.

Changed approach to managing the swine flu pandemic. This letter from NHS Chief Executive David Nicholson updates all NHS staff on the changed approach to managing the swine flu pandemic. The focus has shifted from containment to treatment.

New H1N1v influenza: Current situation and next steps. This letter from Chief Medical Officer Sir Liam Donaldson gives doctors a synopsis of the epidemiology of the new H1N1v (swine flu) virus so far, some pointers as to what might happen next, the rationale for the public health and clinical response so far, information and guidance on steps that now need to be taken and an outline of further planning and policy decision.

A(H1N1) Swine Influenza: Standing up the national pandemic flu service. This letter sets out the Government's plans to roll out a national pandemic flu service to ensure that GPs can focus their efforts on treating patients with more serious symptoms.

Swine flu: UK planning assumptions. This document contains revised planning assumptions in relation to the current swine flu pandemic. The assumptions are intended to assist local planning across all public and private sector organisations. Planning assumptions are for both pan-UK and local areas, to take account of the potential variation in epidemic profile from one local area to another.

National Pandemic Flu Service Letter. This letter from NHS Chief Executive David Nicholson to all NHS staff in England announces the activation of the national pandemic flu service.

A(H1N1) swine influenza: standing up the National Pandemic Flu Service. This letter from Ian Dalton, National Director of NHS Flu Resilience, discusses arrangements for the National Pandemic Flu Service.

Psychosocial Care for NHS Staff During an Influenza Pandemic. This guidance sets out the psychosocial care strategy that NHS and social care organisations need to have in place for supporting staff resilience.

Pandemic flu: ensuring the NHS is ready. This briefing looks at the planning that has already taken place and sets out what boards need to be addressing now ahead of a potential upsurge in flu cases in autumn 2009.  

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Primary Care Trust

Publications/Guidance
Improving eye health services. This document provides practical advice on how PCTs can assess their current eye health services performance, identify their vision for the future and commission services that meet the needs of their local communities.

NHS dentistry review. The Kings Fund have summarised the key recommendations of the major independent review of NHS dentistry published last month, and analysed what these mean for the NHS in the light of other health care reforms.

Primary care and community services: improving GP access and responsiveness. Part of the world class commissioning suite of practical guides, this document builds on existing good practice within the NHS to support PCTs in improving the accessibility and responsiveness of local GP services.

Practice-based commissioning GP Practice Survey: Wave seven. This is the seventh wave of a quarterly survey to get feedback from practices on their perception of the support offered by their primary care trust and on the clinical and financial engagement of practices with practice-based commissioning.

Primary health care for socially excluded groups. This report gives information on progress that has been made to transform the lives and life chances of some of the most vulnerable members of society.

The link between healthcare spending and health outcomes for the new English primary care trusts. Current spending by PCTs on some programmes of care is highly cost-effective, according to this spending and outcomes study by the Health Foundation. The report’s methodology could assist primary care commissioners in deciding what services their money is best spent on and support national policy-makers.

GP Patient Survey results. Ipsos MORI has published the results of the latest Patient Survey carried out between January and April 2009 that assesses patients' experiences of local NHS services. The survey asked patients about a range of issues, such as how easy or difficult it is for patients to make an appointment at their surgery, satisfaction with opening hours, and the quality of care received from their GP and practice nurses. It found that overall satisfaction with surgeries was high at 91%, but there is still room for improvement in accessing GP services, especially getting through on the phone and being able to make appointments more than 48 hours in advance. The results of the survey will be used to allow PCTs to reward practices that are delivering a high standard of access to their patients, as well giving practices information about how they are doing. The results will also help other patients when they need to decide which practice to register with.

A new national template for commissioning NHS Health Checks from community pharmacy. The NHS Health Check Service, a universal systematic, integrated check for all people between the ages of 40 and 74 that is delivered through a variety of providers including community pharmacies, has been rolling out since April 2009. The Chief Pharmaceutical Officer for England, Dr Keith Ridge, has written to PCT Chief Pharmacists to promote a new model template designed to help PCTs who may wish to commission NHS Health Checks from community pharmacy.

Better practices, better health. This report calls for innovative solutions to the challenge of enabling closer working between GPs and community pharmacists. The School of Pharmacy, based at the University of London, believes that without such progress the NHS may not be able to make both service quality improvements and the productivity gains it needs.

PBC two years on: moving forward and making a difference? In 2007, a straw poll of GPs and practice managers by The King's Fund and NHS Alliance found that PCTs were struggling to put in place the basic building blocks of practice-based commissioning (PBC). This report investigates whether PBC has moved forward and whether it has made a difference to patient care. A new poll has found continuing commitment to PBC and optimism about its potential but progress is still hampered by a lack of local vision, a lack of clarity over roles and responsibilities and bureaucratic governance processes.

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

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Prison Health

Publications/Guidance
The Bradley Report and the Government’s response: the implications for mental health services for offenders. This briefing paper echoes Lord Bradley’s call for nationwide coverage of specialist teams to divert people with mental health problems to treatment and support at any stage of the criminal justice system. It calls for Criminal Justice Mental Health teams to become gateways to mainstream mental health services in the community.

Cases
R (P) v Secretary of State for Justice [2009] EWCA Civ 701. Where there was no immediate risk to an offender's life from his regular self-harming and the Secretary of State had relied on medical advice of an appropriately qualified doctor that he did not require hospital treatment, there had been no breach of the European Convention on Human Rights 1950 art.2 or art.3 caused by a delay in transferring him from a young offenders' institution to a psychiatric hospital, and no duty to undertake an inquiry into his detention arose.

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

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Regulation

Publications/Guidance
Extending professional and occupational regulation: the report of the working group on extending professional regulation. This report makes recommendations to the Government as to how decision making on extending regulation could be taken forward. Any recommendations which are progressed and which involve a change of policy would require public consultation, equality and economic impact assessment, and be subject to the costs being affordable within available resources.

Joint statement by the four UK Health Departments on the regulation of clinical physiologists. This statement highlights the commitment of the four Health Departments to the regulation of healthcare scientists. Five groups of healthcare scientists (clinical perfusionists, clinical technologists, clinical photographers, maxillofacial prosthetic technologists and clinical physiologists) have been recommended by the Health Professions Council to the SoS for statutory regulation. The four Health Departments will work with key stakeholders to achieve statutory regulation for these five groups of healthcare scientists for the purpose of improving public protection and patient safety.

Cases
Neath Port Talbot Local Health Board v Gilbey [2009] EWHC 1573 (Admin) (Admin Ct). The court held that the Family Health Services Appeal Authority had not acted irrationally or unreasonably when deciding that a GP should be contingently removed from a list of medical performers. Once it was accepted that conditions imposed on the practitioner were capable of being performed questions about whether the conditions would in fact be performed did not arise, provided that the conditions satisfied the requirement under reg.12 of the National Health Service (Performers Lists) (Wales) Regulations 2004 that they should be designed so as to remove prejudice to the efficiency of services in question.

R (General Medical Council) v Kumar [2009] EWHC 1412 (Admin) (Admin Ct). The court granted an extension of the period of an interim order of suspension of a general practitioner in order to cover the period of a hearing by the GMC Fitness to Practise Panel and allow time for its decision and notification to the doctor.

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

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General

Publications/Guidance
Essence of Care: a consultation on a new benchmark on pain. Essence of Care is a structured system of benchmarks widely used in various health settings. A focus group made up of carers, patients and professionals have met to review the benchmarks and this has led to a proposed new benchmark for pain management. The Department of Health are now opening this up for wider consultation. A consultation has also been launched on the reviewed original benchmarks.

Quality accounts: preparing for publication. High Quality Care for All set out the vision for all providers of NHS Healthcare to provide annual reports to the public outlining the quality of the services they deliver (quality accounts). This letter provides an update on the progress towards their implementation.

Quality accounts engagement report. This report presents findings from the stakeholder engagement on the development of quality accounts in the NHS. The report and recommendations cover four themes: purpose, content, validation and publication of quality accounts.

From feast to famine: reforming the NHS for an age of austerity. Over the past two years the Social Market Foundation (SMF) Health project has examined the future of the NHS in the coming decade, in the face of demographic, technological and now economic change. In the context of a crisis in public finances the report looks at the sustainability of tax funding and asks how an equitable health system can be safeguarded in the years ahead. The report examines whether new measures should be taken to manage demand for health services to relieve pressure on the NHS.

Disturbing symptoms. This report is based on the analysis of responses from commissioners and specialist clinicians to two short surveys distributed in early 2009. The surveys aim to build a picture of the impact of national health policies on sexual health and HIV services.

We’re all in this together: improving the long-term health of the nation. This report is the culmination of the work of the Public Health Commission which was established in 2008 following a request to review a Responsibility Deal to improve public health.

NHS Choices training. This page gives information on a training programme to teach professionals how to use the NHS Choices website with clients. Training includes how to signpost clients to health services, find information on conditions and treatments (including swine flu) and refer clients to healthy living information. The page links to online tutorials and information on free regional workshops.

Assuring design quality in the NHS. This letter invites views from colleagues and stakeholders on achieving quality and sustainability in the physical environment of NHS facilities.

8th Code of Practice, consent forms and Directions. The 8th edition of the Human Fertilisation Embryology Authority’s (HFEA) Code of Practice, updated consent forms and HFEA Directions have now been published. They come into force on 1 October 2009. The 8th Code has been updated to reflect changes in the Human Fertilisation and Embryology Act 2008 and in HFEA policy. The consent forms and Directions have also been updated in line with the amended Act.

Moving Forward: Progress and priorities - Working together for high quality sexual health - Government response to the independent advisory group's review of the sexual health and HIV strategy. This response outlines the progress made in improving sexual health since 2001 and responds to each of the national-level recommendations put forward by an independent advisory group.

Consultations
General Medical Council consultations. Consultation begins on guidance to doctors on research and making and using recordings of patients. Doctors are being asked for their views on three pieces of draft GMC guidance. These are "Good practice in research", "Consent to research", and "Making and using visual and audio recordings of patients." These new pieces of guidance will update existing publications Research: the role and responsibility of doctors (2002) and Making and using visual and audio recordings of patients (2002). The draft pieces of guidance take account of changes to the law and new GMC guidance on consent and confidentiality. The consultations close on 25 September 2009.

Health protection regulations: A consultation. Seeks views on three sets of draft health protection regulations to be made under the Public Health (Control of Disease) Act 1984, to continue the process of modernising health protection legislation in England. The regulations cover requirements for notification of disease caused by infection or contamination by chemicals or radiation, to allow prompt investigation and response; evidential requirements and safeguards for people who might be subject to a JP order under the amended Act; and updated local authority powers to protect public health. The consultation closes on 30 September 2009.

Three-digit number (3DN) to access non-emergency health care. Following a major review of NHS services in 2007/8, the NHS Next Stage Review Final Report, High Quality Care For All, committed the DH to explore the benefits of introducing a new, memorable, three-digit telephone number to help people find the right local service to meet their non-emergency but urgent, unplanned care needs. This Ofcom consultation seeks views on proposals for the single number and the tariff. The suggested number 111 will not replace existing local telephone services or NHS Direct but it will provide patients with an additional choice in how they find urgent care. In the long-term, 111 could become the single number to access non-emergency care services in England, including NHS Direct. The three-digit telephone number will initially be piloted in a number of SHA areas in England from Spring 2010 but the intention is for the service to be fully rolled out across England in the long-term, subject to a positive evaluation of those pilots. The consultation closes on 20 August 2009.

The Marmot Review - strategic review of health inequalities. An interim report on the evidence and emerging themes of the independent strategic review of health inequalities post 2010, led by Professor Sir Michael Marmot, has been published for consultation. Comments must be submitted by 5 August 2009.

News
Access to NHS services for foreign nationals. A joint DH and Home Office review group has published its findings on a review into access to the NHS by foreign nationals. The review, launched in 2007, set out to examine the rules on charging non-UK residents for access to NHS services in England. The Government has concluded that there should not be any significant change for either primary or secondary care. It has now agreed on a number of proposals, which will be consulted on in the autumn.

Failed asylum seekers health help. Failed asylum seekers in England are still refused free health care. However, failed asylum seekers in Wales who have been told they cannot stay in Britain can now have access to free NHS care.

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