05/05/2010
Legal intelligence for professionals in health and social care
This Update contains brief details of recent Government publications, legislation, cases and other developments relevant to those involved in health and social care work, which have been published in the last month.
If you have been forwarded this update by a colleague and would like to receive it directly, please email Claire Bentley.
Care
Publications/Guidance
Shaping the future of care together: report on the
consultation. This report summarises responses to the
Government's Big Care Debate consultation on the proposals in the
Green Paper ‘Shaping the Future of Care Together’.
NHS continuing healthcare practice guidance.
This practice guidance supports practitioners and others with
responsibilities for NHS continuing healthcare in the
implementation of the National Framework for NHS Continuing
Healthcare and NHS-funded Nursing Care. It provides a practical
explanation of how the Framework should operate on a day-to-day
basis and cites examples of good practice.
Building the National Care Service. This White
Paper sets out the Government's proposals to build a comprehensive
National Care Service (NCS) for all adults in England with an
eligible care need, free when they need it. The NCS will mean that
people will be treated with dignity and respect, people will have
control and choice over their care and they will be helped to stay
in their homes for as long as possible. People who have to live in
residential care will, from 2014, get their care for free after two
years and there will be more help to pay the residential costs.
This will be phased in three stages.
Consultations
Consultation on interim registration fees for
providers of adult social care and independent health care.
This consultation seeks views on a proposed fees scheme for
independent healthcare and adult social care providers who will be
registered under the Health and Social Care Act 2008 from 1 October
2010. The consultation closes on 16 June 2010.
Legislation
Personal Care at Home Act 2010. This Act has
received Royal Assent. It comes into force on a day to be
appointed. The Act will provide for those with the greatest care
needs to be offered free personal care at home. Existing powers
allow local authorities to provide certain community care services
free of charge for up to six weeks. The Act removes this time limit
in respect of personal care at home for those in the greatest need.
The Government estimates that the Act would help around 400,000
people with care needs and guarantee free personal care for the
280,000 people with the greatest need. The legislation is intended
to be the first step towards establishing a new National Care
Service.
News
£40 million capital budget for hospices.
Announces the successful hospices that will share £40m funding
under the End of Life Care Strategy. The funding was made available
through a competitive scheme, run on behalf of the DH by Help the
Hospices. Hospices were invited to submit projects which would
deliver tangible physical improvements in their care environments,
and show how this would contribute to improved care provision. The
press release includes a link to a list of the successful
hospices.
If you wish to discuss any of the items raised in this section please contact Neil Grant.
Children
Publications/Guidance
NHS services and children's centres - how to share
information appropriately with children's centre staff. Sets
out the framework for information sharing between all practitioners
based at a children’s centre, so that information can be shared
appropriately. It focuses particularly on sharing information
relevant to delivering effective health services via a children’s
centre. The leaflet sets out the legal context, and explains
different approaches to sharing information on a case by case
basis, and pre-planned bulk sharing of information. It flags the
important distinction between the need for centres systemically to
have access to basic personal information, and the need to share
more detailed information on a case by case basis.
Children's heart surgery - the need for change. This document reviews how children’s heart surgery services are currently provided in England and suggests new ways to deliver these services so that all children have equal access to the highest standards of care.
One year on - the first report from the National Advisory Council for children's mental health and psychological wellbeing. This report looks at examples of progress of the CAMHS review, but also at the many challenges that need to be tackled if the Review recommendations are to be achieved. It outlines how the National Advisory Council will continue to work with young people, Government and the field to stimulate more open debate and to find solutions in the current economic climate.
One year on: Healthy lives, brighter futures: the strategy for children and young people’s health. This letter from Andy Burnham, Secretary of State for Health and Ed Balls, Secretary of State for Children, Schools and Families provides an update on the child health strategy which was launched a year ago.
National Framework for Children and Young People's Continuing Care. This framework sets out an equitable, transparent and timely process for assessing, deciding and agreeing bespoke packages of continuing care for those children and young people under the age of 18 who have continuing care needs that cannot be met by existing universal and specialist services alone.
Cases
M.A.K. v United Kingdom 45901/05 [2010] ECHR 363
(ECtHR). The court held that, while there were relevant and
sufficient reasons for the authorities to suspect that a child had
been abused at the time when she was admitted to a hospital, a
delay in consulting a dermatologist, who could have diagnosed the
child's skin condition some days earlier, interfered with the right
of the child and her father to respect for their family life and
was not proportionate to the legitimate aim of protecting the child
from harm. Also, there was no justification, in the circumstances,
for a decision to take a blood test and intimate photographs of a
child, against the express wishes of both her parents, while she
had been alone in the hospital. Accordingly, there had been
breaches of Art.8 ECHR.
News
£30 million boost for sick children's care.
Announces funding for children’s hospices and children’s palliative
care services, that will help hospices extend the range of their
services to include more outreach. It will help the NHS continue to
move their palliative care services out of hospitals and into
children’s own homes.
If you wish to discuss any of the items raised in this section please contact Penelope Radcliffe, Tracey Lucas or Deborah Jeremiah.
Clinical Management
Publications/Guidance
Putting quality first in the boardroom: improving
the business of caring. This report is based on observations of
nurse executives and their boards at six NHS trusts. The report
starts by examining what is meant by the term ‘clinical quality’
and why it has the potential to be marginalised in the boardroom.
It goes on to consider the dynamics of the boardroom and the role
of the nurse executive. The main observations of the report relate
to board members’ behaviour and attitudes to the question of
discussing and improving clinical quality.
News
Revealed: new designs transform patients' privacy
and dignity in NHS hospitals. Announces the launch of new
design prototypes to improve patient privacy and dignity. The
prototypes are the culmination of Design for Patient Dignity, a
programme from the Department of Health and Design Council, which
has brought together seven teams of leading UK designers and
manufacturers with frontline healthcare staff to help solve privacy
and dignity issues for patients. They include revolutionary "bed
pods" and screening systems, modular toilets and washrooms, and a
redesigned patient gown.
Majority of NHS trusts declare same-sex accommodation.
Announces that 95 per cent of trusts have confirmed that they have
virtually eliminated mixed-sex accommodation from hospitals across
England. This follows an intensive government drive and a £100m
Privacy and Dignity Fund set up by the DH last January to help
trusts improve their hospital environments and patient privacy and
dignity.
If you wish to discuss any of the items raised in this section please contact Jackie Linehan.
Clinical Research
Publications/Guidance
Good practice in research and consent in
research. This guidance sets out the good practice principles
that doctors are expected to understand and follow if they are
involved in research.
Consultations
Give and take? Human bodies in medicine and
research: consultation paper. This Nuffield Council on
Bioethics consultation paper seeks views on the extent to which
people should be encouraged or incentivised to donate organs, eggs
and sperm; the control a person providing such material should have
over its future use; and whether useful comparisons can be made
with people taking part in "healthy volunteer" trials. Comments by
13 July 2010.
Commissioning
Publications/Guidance
Commissioning: fourth report of session
2009-10. This report looks at the history of commissioning, the
present system and its weaknesses. It also looks at the effects of
wider reforms in the NHS on commissioning and makes recommendations
for the future.
Where next for commissioning in the English NHS?
This report uses research evidence as the basis for examining
current commissioning arrangements, analyses the nature of the
‘commissioning problem’, and sets out practical suggestions for how
commissioning might be strengthened to meet the challenges
ahead.
Invest in engagement. This is a new online resource designed for NHS commissioners and providers, and anyone with an interest in patient and public engagement. It provides an evidence review of the effectiveness of PPE in health and evidence-based recommendations for investing in engagement. Alongside the evidence, Invest in Engagement offers other resources including case studies, links to sources of help and policy guidance.
The NHS Performance Framework: implementation
guidance 2010/11. This guidance supports the application of the
NHS Performance Framework; informs SHAs as the regional system
managers and PCTs as the local commissioners of NHS services of
when they should intervene to address poor performance; and informs
NHS organisations of the criteria against which their performance
will be assessed.
Principles and rules of cooperation and
competition. This document sets out revised PRCC in
commissioning and provision of NHS services. The PRCC were first
issued under the 2007/08 Operating Framework and are intended to
support cooperation and competition in the interests of patients
and taxpayers in relation to: commissioning and procurement;
cooperation and collusion; conduct of individual organisations; and
mergers and vertical integration. These new PRCC will supersede the
original PRCC of December 2007 from October 2010 onwards.
Cross-border healthcare and patient mobility: revised advice on handling requests from patients for treatment in countries of the European Economic Area - guidance for the NHS. These Regulations, Secretary of State's Directions and guidance aim to help local health commissioners handle requests from the public to go to other European Economic Area under arrangements based on the freedom to provide services in Article 56 of the Treaty of the European Union. Cross-border healthcare and patient mobility: revised advice on handling requests from patients for treatment in countries of the European Economic Area - guidance for the NHS.
If you wish to discuss any of the items raised in this section please contact David Owens.
Complaints
Bevan Brittan Portal
At Bevan Brittan we have set up an e-portal to assist complaints
managers in the NHS. The portal is of use to all NHS complaints
managers who are often handling very sensitive and complex work. It
provides tailored access to a range of up-to-date knowledge and
information enabling you to have a central, structured and focused
source of information on complaints. It also has a discussion forum
for use by complaints managers to share tips and
knowledge with each other. You may like to take a look
at the forum and see what colleagues have posted about different
topics. In
addition you may want to write a post/query of your own. If you would like more
information about the portal please contact Claire
Bentley.
Bevan Brittan Training
Complaints and Claims Forum. 16 June 2010 : Lcation:
Fleet Place House, 2 Fleet Place, Holborn Viaduct, London EC4M
7RF.
Complaints & Claims Forum. 01 December 2010 : Location: Fleet Place House, 2 Fleet Place, Holborn Viaduct, London EC4M 7RF.
Data Protection
Publications/Guidance
NHS services and children's centres - how to share
information appropriately with children's centre staff. Sets
out the framework for information sharing between all practitioners
based at a children’s centre, so that information can be shared
appropriately. It focuses particularly on sharing information
relevant to delivering effective health services via a children’s
centre. The leaflet sets out the legal context, and explains
different approaches to sharing information on a case by case
basis, and pre-planned bulk sharing of information. It flags the
important distinction between the need for centres systemically to
have access to basic personal information, and the need to share
more detailed information on a case by case basis.
Caldicott Guardian Manual 2010. The manual takes account of developments in information management in the NHS and in councils with social services responsibilities since the publication of the Caldicott report. It sets out the role of the Caldicott Guardian within an organisational Caldicott/confidentiality function as a part of broader information governance.
If you wish to discuss any of the items raised in this section please contact James Cassidy .
Emergency Planning
Publications/Guidance
NHS emergency planning guidance: Planning for the
development and deployment of Medical Emergency Response Incident
Teams in the provision of advanced medical care at the scene of an
incident. This is best practice guidance to NHS organisations
for developing and deploying medical emergency response incident
teams.
NHS emergency planning guidance: The ambulance
service guidance on dealing with radiological incidents and
emergencies. This document describes the role of NHS ambulance
trusts in planning, preparing and responding to radiation incidents
and emergencies involving irradiated and contaminated people.
If you wish to discuss any of the items raised in this section please contact Simon Lindsay.
Employment/HR
Publications/Guidance
Planning and Developing the NHS Workforce. This
document is designed to support strategic health authorities in
leading the debate about the future shape of services and what this
means for workforce skills, competences, numbers and locations.
SHA Assurance reports. SHA Assurance is designed to support the
development of SHA capability and capacity. This report and its covering letter summarise the
findings of the assurance process and detail the Panel's
recommendations to the North West SHA following their visit.
Similar reports have been published for the South East Coast SHA, the South West SHA and the East of England SHA.
Commercial skills for the NHS. Sets out a strategy for supporting staff to develop their commercial skills and for supporting local commissioners and providers by facilitating access to specialist commercial expertise and infrastructure at regional and national level. It supersedes "Necessity not Nicety – a new commercial operating model for the NHS" (May 2009).
Uniforms and workwear: guidance on uniform and workwear policies for NHS employers. In 2007, the Department of Health published 'Uniforms and Workwear: an evidence base for developing local practice'. This revision takes account of comments and feedback from employers and staff as local policies have been implemented. It re-affirms the principles of the original guidance with particular reference to staff dress during direct patient care activity.
A framework for staff engagement: An introduction to staff engagement in the NHS and guidance on starting staff engagement policy. This is an introduction to achieving staff engagement in the NHS.
Cases
Gillian Clare Mezey v South West London & St
Georges Mental Health NHS Trust [2010] EWCA Civ
293 It was not permissible for an NHS trust to hold
a capability hearing under the relevant disciplinary procedure
where a consultant psychiatrist's competence had been vindicated by
an investigation.
Bevan Brittan Updates
April News Round-Up. Marie-Claire Boyle sets out the
latest employment law related news.
Employer restrained from starting capability procedure. In Mezey v South West London and St George’s Mental Health NHS Trust, the Court of Appeal has confirmed, for the first time, that an employee may use an injunction to stop an employer from pursuing a disciplinary procedure. Julian Hoskins examines the detail and sets out the impact of this decision.
Exit costs at the end of outsourcing contracts. A recent survey has highlighted the fact that many contractors who take on outsourced local authority services are unaware of some of the key concerns on pension costs. Christine Johnston examines the issues.
Manifesto Destiny. There are absolutely no prizes for guessing what is happening in politics on 6 May this year. But what are each of the main parties promising in terms of employment law, should they win the election? Raj Basi assesses the key policies that impact on employment law.
Finance
Publications/Guidance
Direct payments for health care: a consultation on
proposals for regulations and guidance. The Government's
response. Sets out the Government's response to the October
2009 consultation on proposals for using the powers in the NHS Act
to make regulations to enable pilot sites to use personal health
budgets in the form of direct payments. The consultation responses
have reinforced the Government's belief that piloting and robust
evaluation are essential. This is a complex and challenging policy,
and it does not yet have answers to all the questions raised.
Following the pilot programme and in light of the evaluation and
lessons learned, there will be a further review of the regulations
and guidance, if a decision is taken to roll out personal health
budgets more widely. This is likely to include a further period of
public consultation. Annex A sets out a number of specific changes
to the proposals for regulations.
NHS continuing healthcare: refunds guidance. This guidance sets out the approaches to be taken by PCTs and local authorities when a decision is awaited on eligibility for NHS continuing healthcare or there is a dispute following a decision. It explains responsibilities for providing services during these periods and for refunding the costs of services provided.
NHS accounts guides for non-executives and governors. The Audit Commission and the Healthcare Financial Management Association have revised their guides which help non-executives and governors to get a more detailed grasp of their organisation's annual accounts. The guides explain the role of the non-executive director or governor and the external auditor. They also include an invaluable list of questions to help understand and gain assurance on the detail of the financial statements. The guides were originally developed in 2007 and have now been updated for 2010 to reflect changes following the introduction of the International Financial Reporting Standards.
NHS trust accounts: A guide for
non-executive directors;
Primary care trust accounts: A guide for
non-executive directors;
Foundation trust accounts: A guide for
non-executive directors; and
Foundation trust accounts: A guide for
governors.
Detailed guidance for the dry-run of external assurance on the quality reports. Detailed guidance for NHS foundation trusts and their auditors to enable them to carry out the dry run of the external assurance proposals on the 2009/10 Quality Reports (or state of readiness review), as specified in para.7.74 of the Annual Reporting Manual 2009/10, issued on 16 April 2010.
Legislation
National Health Service (Direct Payments)
Regulations 2010 (SI 2010/1000). These regulations, which come
into force on 1 June 2010, are made under ss.12A-12C NHS 2006, as
inserted by the Health Act 2009. They allow the Secretary of State
to set up pilot schemes for direct payments for health care or
mental health aftercare, as part of a wider pilot programme
exploring the use of personal health budgets.
If you wish to discuss any of the items raised in this section please contact Claire Bentley.
Foundation Trusts
Publications/Guidance
Governors in NHS Foundation Trusts: What the law
says you have to do. This is an easy read version of: Your statutory duties: a reference guide for NHS
foundation trust governors (published October 2009) that
examines ways in which governors can deliver their statutory
duties. It sets out these duties, and provides suggested process
steps to deliver them. These process steps are advisory and reflect
best practice.
NHS Foundation Trust Annual Reporting Manual
2009-10 (previously titled: Foundation Trust Financial Reporting
Manual 2009-10). Provides guidance to foundation trusts on
producing their annual reports and accounts. This document was
previously called the NHS Foundation Trust Financial Reporting
Manual 2009/10 (FT FReM); it has been renamed to reflect the
enhancements made to the manual following consultation on
additional reporting requirements.
2009-10 annual accounts guidance for NHS foundation
trusts. Guidance for NHS foundation trusts to aid in the
completion of their 2009-10 Foundation Trust Consolidation
templates. These templates will be used by Monitor to produce the
2009-10 Consolidated Foundation Trust Accounts.
Monitor: Compliance framework 2010-2011. Sets out the approach Monitor will take to assess the compliance of NHS foundation trusts with their Terms of Authorisation.
Consultation on seeking external assurance on the Quality Accounts of NHS foundation trusts - summary of consultation responses. Sets out Monitor's comments on the December 2009 consultation, together with a summary of responses received. The majority of respondents were supportive of the need for external assurance on the quality accounts; however there were reservations in relation to the inclusion of a Directors’ Statement in the quality accounts in 2009/10 and the timescale for the delivery of the final private report. Some concerns were also raised that further clarification was required on the criteria to support the opinion on the arrangements in place to ensure the quality accounts are fairly stated (the arrangements opinion). Monitor has amended its guidance in light of these concerns.
New foundations: the future of NHS Trust
providers. This briefing compiles the results of a snapshot
survey carried out by the Royal College of Nursing which aimed to
evaluate the performance, engagement and quality of care in NHS
Foundation Trusts in England.
NHS foundation trust annual reporting manual 2009-10. This
document provides guidance to foundation trusts on producing their
annual reports and accounts. It was previously called the NHS
Foundation Trust Financial Reporting Manual 2009/10 and has been
renamed to reflect the enhancements Monitor have made to the manual
following consultation on additional reporting requirements.
Monitor has published detailed guidance for the dry run of external assurance on quality reports. The dry run of proposals (or state of readiness review) that will be undertaken on the 2009/10 Quality Reports will require NHS foundation trusts to:
- include a brief description of the key controls in place to prepare and publish a Quality Report in the Statement on Internal Control in the 2009/10 published accounts;
- sign a proforma Statement of Directors’ Responsibilities in respect of the 2009/10 Quality Report to provide to their auditors (this is not required to be published in the 2009/10 Quality Report);
- provide their auditors with a paper which explains the arrangements the trust has put in place to prepare and publish the Quality Report against Monitor’s guidance (it is anticipated that this will include the relevant trust board paper which the board considered to allow the chief executive to sign the statement that the Quality Accounts are accurate, which is a requirement under the Department of Health’s regulations); and
- submit a copy of their auditors’ report on the outcome of the dry run to Monitor and to the trust’s board of governors.
Bevan Brittan Updates
Detailed Guidance for the Dry-Run of External Assurance
on the Quality Reports. Monitor has recently issued a
detailed guidance for the Dry-Run of External Assurance on Quality
Reports. The guidance sets out the requirements of Foundation
Trusts and their Auditors, and gives details of the criteria that
Monitor require Foundation Trusts to be judged against. It is very
important that Foundation Trusts act upon the guidance, as it they
are required to undertake the dry-run. In addition, the guidance
sets out positive obligations on them to provide certain
information to their Auditor and fairly tight timetables from
submission of the Quality Report to Monitor by the Foundation
Trust, to the submission of the Auditor's report.
If you wish to discuss any of the items raised in this section please contact Vincent Buscemi.
Governance
Publications/Guidance
Putting quality first in the boardroom: improving
the business of caring. This report is based on observations of
nurse executives and their boards at six NHS trusts. The report
starts by examining what is meant by the term ‘clinical quality’
and why it has the potential to be marginalised in the boardroom.
It goes on to consider the dynamics of the boardroom and the role
of the nurse executive. The main observations of the report relate
to board members’ behaviour and attitudes to the question of
discussing and improving clinical quality.
Healthcare Associated Infection
Publications/Guidance
MRSA screening - operational guidance 3. The
guidance contained in this letter is aimed primarily at Chief
Executives and Directors of Performance. It will also be of
interest to Finance Directors, Directors of Nursing and Medicine,
Directors of Infection Prevention and Control and their teams,
medical microbiologists, laboratory managers, bed managers and
those running pre-admission clinics and admission units.
C. Difficile Methodology. This update gives information on progress in reducing C.difficile infections and a new objective.
Consultations
Consultation on the Health and Social Care Act 2008
Code of Practice for healthcare, including primary care, and adult
social care on the prevention and control of infections and related
guidance. This consultation seeks views on a code of practice
and supporting guidance that will help providers of healthcare,
including primary care, and adult social care to plan and implement
how they prevent and control healthcare-associated infections. It
sets out criteria that the Care Quality Commission will use to
assess compliance with the registration requirement. The
consultation closes on 24 June 2010.
If you wish to discuss any of the items raised in this section
please contact
Sian Morgan.
Inquests
Publications/Guidance
Guidance for Coroners and Donor Coordinators
Working with Coroners. This guidance encourages the development
of local protocols to optimise organ donation.
Cases
Glennys Jones (Applicant) v HM Coroner for the Southern District of
Greater London (Respondent) & Deshminder Virdi (Interested Party)
[2010] EWHC 931 (Admin) It was appropriate for an open verdict to
be quashed and a new inquest ordered where there had been
insufficient inquiry made into the means by which a deceased came
to die from fentanyl toxicity. There was also a wider public
interest in a full inquiry given that there had been a considerable
number of deaths in the United States and the United kingdom linked
to unintended overdoses of fentanyl.
If you wish to discuss any of the items raised in this section please contact Joanna Lloyd or Nadia Persaud.
Mental Health
Publications/Guidance
Implementing recovery: a methodology for
organisational change. This paper helps mental health services
to measure how well placed they are to support the people who use
them. It sets out the three stages a service needs to reach on ten
key challenges to become fully focused on recovery. It allows
mental health services, their users and their commissioners to
judge how well they are doing in meeting each of the ten
challenges.
Valuing People Now delivery plan 2010-11. The delivery plan for 2010-11 has been published together with a range of materials to support the implementation of Valuing People Now, the cross government strategy for people with learning disabilities. The plan sets out the key priorities for 2010-11, in particular, to improve employment and housing opportunities and better health outcomes for people with learning disabilities and their family carers.
Voting rights for detained patients. This
Guidance Note is to give information to NHS Trusts and independent
hospitals on the voting rights of detained patients, and to advise
patients of their entitlement to vote, and how they may register to
vote.
Attitudes to Mental Illness 2010. This report
presents the results of the latest survey on public attitudes to
mental illness.
Mental health system reform: towards delivering New
Horizons and Quality and Productivity. This letter relates to
the range of systems reforms that come into effect in 2010/11 and
that will affect how mental health services are commissioned,
performance managed, and incentivised to deliver improvements in
quality, efficiency and responsiveness.
Acute awareness: improving hospital care for people
with dementia. This report looks at the key issues for NHS
trusts in improving care for patients with dementia, the majority
of whom will have been admitted for another condition. It showcases
the innovative work that NHS trusts and cross-agency partnerships
are undertaking in this area to enhance patient care and describes
how significant improvements can be achieved in terms of both the
quality and efficiency of patient care.
Update on the Latest Developments on Payment by
Results for Mental Health, and Clarification of Implementation.
This letter provides an update on the latest developments on
payment by results for mental health, as well as clarifying the
timescales for its implementation.
Human rights training materials and human rights
resources. This resource forms a suite of training materials
designed for use in training sessions for frontline workers -
primarily health and social care workers - supporting people with a
learning disability. The resources will assist trainers and
interested parties as to the range of materials available.
Housing rights resource pack. This suite of
resources covers many subjects around different housing options
available for people with learning disabilities.
Towards 'Fulfilling and rewarding lives': the first
year delivery plan for adults with autism in England. This plan
sets out the governance structure and the actions, with timescales
and responsibilities, that will be taken in the first year to
support the implementation of the strategy for adults with autism
in England.
Office of the Public Guardian: amendments to
secondary legislation - Response to Consultation. Following a
consultation proposing changes to secondary legislation to ensure
the Mental Capacity Act 2005 meets its aims and objectives, two
statutory instruments have been laid in Parliament which are due to
come into force on May 1, 2010. The changes include: reducing the
security bond discovery period after a client's death from seven to
two years for all new bonds taken out on or after May 1, 2010;
adding local housing allowance to the list of benefits that qualify
a customer for exemption from Office of the Public Guardian fees;
and allowing the Public Guardian to investigate enduring power of
attorneys.
My name is not dementia. The Alzheimer's
Society has undertaken a new project focusing on quality of life in
dementia. This new report presents the findings of the first stage
of this project. The research was carried out by the Mental Health
Foundation over 2009/10 and aims to better understand key quality
of life indicators for people with a dementia diagnosis. A literature review has been published alongside
this report.
NHS standard contract for high secure services 2010/11. The DH has
issued a new standard contract for high secure services for use
from April 2010 by the three Specialised Commissioning Groups
responsible for commissioning high secure services to cover the
services provided at Ashworth, Rampton and Broadmoor High Secure
Hospitals, with guidance. It should be read alongside with the
contract guidance published to support the implementation of the
NHS standard contract for mental health and learning disability
services.
Update on the latest developments on PbR for Mental
Health, and clarification of implementation timescales. This
Dear Colleague letter from Bob Alexander, Director, NHS Finance and
Bruce Calderwood, Director, Mental Health Policy, provides an
update on the latest developments on Payment by Results (PbR) for
Mental Health, as well as clarifying the timescales for its
implementation.
Confident communities, brighter future: a framework
for developing wellbeing. This DH report sets out the first
framework for mental well-being and aims to provide an evidence
base from which local authorities and the NHS can act to reduce
inequalities and improve mental health in their areas.
Valuing People Now Delivery Plan 2010-11.This
marks the progress made in the first year of Valuing People Now,
the cross-government strategy for people with learning
disabilities. It also recognises that there is still more to do to
improve the lives of people with learning disabilities and their
family carers. The Delivery Plan sets out the key priorities for
2010-11, in particular, to improve employment and housing
opportunities and better health outcomes for people with learning
disabilities and their family carers.
One year on - the first report from the National
Advisory Council for children's mental health and psychological
wellbeing. This report looks at examples of progress of the
CAMHS review, but also at the many challenges that need to be
tackled if the Review recommendations are to be achieved. It
outlines how the National Advisory Council will continue to work
with young people, Government and the field to stimulate more open
debate and to find solutions in the current economic climate.
Legislation
National Health Service (Direct Payments)
Regulations 2010 (SI 2010/1000). These regulations, which come
into force on 1 June 2010, are made under ss.12A-12C NHS 2006, as
inserted by the Health Act 2009. They allow the Secretary of State
to set up pilot schemes for direct payments for health care or
mental health aftercare, as part of a wider pilot programme
exploring the use of personal health budgets.
News
First "Health and Criminal Justice Tsar"
announced. Professor Louis Appleby has been appointed the first
National Clinical Director for Health and Criminal Justice,
responsible for delivering the Government's action plan, "Improving
Health, Supporting Justice", which aims to address health and
social care problems as early as possible in a person's contact
with the criminal justice system and to develop more effective
interventions for offenders. His deputy, Dr Hugh Griffiths, will
take on responsibility for wider mental health issues.
Bevan Brittan Updates
Barber v Croydon LBC - the gateway opens again. In our last
edition of Housing Landscape we considered some of the practical
effects on social housing providers following the recent cases of
Kay v Lambeth, Weaver and Doherty in view of the likelihood that
public law defences were likely to be increasingly relied on by
tenants in housing disputes. This article examines the decision of
the Court of Appeal in Barber v Croydon LBC on 11 February 2010 - a
case in point.
Bevan Brittan Training
Mental
Health. 03 November 2010 : Location:
Kings Orchard, 1 Queens Street, Bristol BS2 0HQ
Mental Health. 20 October 2010 : Location: Interchange Place, Edmunds Street, Birmingham B2 2TA
Mental Health. 12 October 2010 : Location: Fleet Place House, 2 Fleet Place, Holborn Viaduct, London EC4M 7RF
If you wish to discuss any of the items raised in this section please contact Simon Lindsay.
Obesity
Publications/Guidance
Healthy Weight, Healthy Lives: a research and
surveillance plan for England - update on progress. This
document includes an overview of key strategic developments and
partnerships on developing the evidence base on obesity since the
publication of Healthy Weight, Healthy Lives: a research and
surveillance plan for England. It recognises that developing the
evidence base is an ongoing progress and a long-term venture.
However, even within this first year, considerable progress has
been made in terms of building upon existing infrastructure and
investments.
If you would like more information about any of the items in this section please contact Julie Chappell.
Primary Care Trust
Publications/Guidance
The NHS performance framework: implementation
guidance 2010/11. The aim of this guidance is to support the
application of the NHS Performance Framework; to inform SHAs as the
regional system managers and PCTs as the local commissioners of NHS
services of when they should intervene to address poor performance;
and to inform NHS organisations of the criteria against which their
performance will be assessed.
Improving oral health and dental outcomes:
developing the dental public health workforce in England. This
report gives guidance on developing the dental public health
workforce to enable PCTs and SHAs to promote oral health, increase
access to dental services and secure safe, high quality dental
services which meet the needs of the local population.
Primary Care Trust procurement guide for health
services. Sets out expectations of PCT Boards on the use of
procurement to improve services for patients. The guidance is
consistent with law, including the application of the UK Public
Contracts Regulations to commissioning of health services and
reflects overarching principles of transparency, proportionality,
non-discrimination and equality of treatment. The guide is
referenced in the NHS Operating Framework for 2010/11. It should be
read in that context and in conjunction with the revised Principles and rules of cooperation and
competition and the national standard contracts guidance.
Guidance: GP extended hours access. Guidance for PCTs on maximising the availability of GP extended opening hours. The guidance should be read in conjunction with the Primary Medical Services (Directed Enhanced Services) (England) Directions 2010 (the DES Directions) and the amendments to the Statement of Financial Entitlements (SFE).
Practice Based Commissioning Group and Independent Leads Survey: Wave 2. This is the second wave of research for the new practice based commissioning (PBC) survey, conducted between February and March 2010. The previous PBC GP practice survey (August 2007 – September 2009) asked GP practices for their views of PBC. For this new survey, lead individuals within PBC groups and independent practices have been invited to take part as they are ideally placed to provide informed feedback as to their organisation’s experience of PBC locally. The aims of the survey are to get feedback from practices on their perception of the support offered by their PCT and on the clinical and financial engagement of practices with PBC.
The DH has issued Pharmacy in England: building on strengths - delivering the future - Regulations under the Health Act 2009: pharmaceutical needs assessments. Information for primary care trusts that provides information to assist PCTs in publishing their pharmaceutical needs assessments. It explains and expands on the regulations.
Health inequalities in ex-coalfield and industrial communities. This publication looks at the issue of regeneration of former coalfield areas. It asks whether health has been overlooked in the past, and how former coalfield areas might move forward in tackling health inequalities. The document is targeted at councillors with a health remit, as well as council and PCT staff with a responsibility for health improvement and reducing health inequalities.
Talking it through: the importance of communications when discussing local service change. This report discusses how PCTs can communicate important decisions locally in a transparent way to help improve public understanding and constructive involvement. Although this report focuses on communications during local service reconfigurations, some of the findings can be applied to other high-profile local decisions such as drug funding.
Developing tariffs for integrated sexual health
services. This briefing document outlines the development of
the London Sexual Health Programme tariff which is an agreed set of
currencies for integrated sexual health services to be paid by PCTs
to providers of sexual health services.
NHS continuing healthcare refunds guidance.
This DH guidance sets out the approaches to be taken by PCTs and
local authorities when a decision is awaited on eligibility for NHS
continuing healthcare or there is a dispute following a decision.
It explains responsibilities for providing services during these
periods and for refunding the costs of services provided.
Legislation
National Health Service (Performers Lists)
Directions 2010. These Directions, which come into effect from
1 April 2010, require PCTs to review procedures for managing
Performers Lists within three months and to implement any changes
by the end of the financial year 2010/11. This follows the recent
GP Out of Hours report and the inquest into the death of David
Gray. The Directions need to be read in conjunction with the
National Health Service (Performers Lists) Regulations 2004 (SI
2004/585) and subsequent amendment.
Bevan Brittan Updates
Department of Health Recommendations to PCTs in relation to Out of
Hours Services The Department of Health has recently undertaken
a review of the current arrangements for general practice out of
hours ("OOH") services, and published the findings of its review in
January 2010 (the "Review"). The Review makes a number of
recommendations to PCTs as both commissioners and providers of OOH
services.
New Performers Lists Directions: PCT List Management Procedures due for Review. The Secretary of State has issued Directions to PCTs which require PCTs to review and implement a range of procedures in relation to the management of Medical, Dental and Ophthalmic Performers Lists. The Directions require PCTs to undertake a series of reviews by 1 July 2010, to implement the relevant procedures at the earliest opportunity, but no later than 31 March 2011, and to continually undertake reviews moving forward. To assist PCTs, we have produced a short guide to the Directions explaining what PCTs need to do now and over the next 12 months.
Bevan Brittan Training
Untwist
your List. With the raft of recent
changes affecting primary care performers list management, the onus
is on PCTs more than ever to ensure that their Performers lists are
fit for purpose. 18 May 2010 : Registration: 9.30am
Seminar: 10am - 12.30pm. Location:
Fleet Place House, 2 Fleet Place, Holborn Viaduct, London EC2M
7RF
If you wish to discuss any of the items raised in this section please contact David Owens.
Prison Health
Publications/Guidance
Independent Advisory Panel on Deaths in Custody. This
is the website of the independent advisory panel on deaths in
custody. The panel will play an important role in helping to shape
government policy in this area through the provision of independent
advice and expertise to the Ministerial Board on Deaths in
Custody.
Cases
Akhmetov v Russia (No.37463/04) [2010] ECHR 441
(ECtHR). The court held that, where a prisoner had been
receiving conservative treatment for his rare and complex medical
condition but the prison authorities were aware that the
recommended radical treatment was not possible within the
penitentiary system, their delay in seeking such treatment in a
civilian hospital, with the consequence that the condition became
irreversible, breached Art.3 of the European Convention on Human
Rights 1950.
News
First "Health and Criminal Justice Tsar"
announced. Professor Louis Appleby has been appointed the first
National Clinical Director for Health and Criminal Justice,
responsible for delivering the Government's action plan, "Improving
Health, Supporting Justice", which aims to address health and
social care problems as early as possible in a person's contact
with the criminal justice system and to develop more effective
interventions for offenders. His deputy, Dr Hugh Griffiths, will
take on responsibility for wider mental health issues.
Bevan Brittan Training
Annual Prison Health Update. 09 December 2010 : Location:
Fleet Place House, 2 Fleet Place, Holborn Viaduct, London EC4M
7RF
If you wish to discuss any of the items raised in this section please contact Nadia Persaud.
Regulation
Publications/Guidance
New registration guidance for adult social care and
independent healthcare. All adult social care and independent
healthcare providers that carry on regulated activities must apply
to be registered with CQC under a new registration system from 1
October 2010. The CQC have now opened the first two 'application
windows'. The How to apply and How to complete your application form booklets
provide important information. The CQC have also developed an
e-learning module to guide applicants through
the correct procedures.
Monitor: Compliance framework 2010-2011. Sets out the approach Monitor will take to assess the compliance of NHS foundation trusts with their Terms of Authorisation.
Consultation on seeking external assurance on the Quality Accounts of NHS foundation trusts - summary of consultation responses. Sets out Monitor's comments on the December 2009 consultation, together with a summary of responses received. The majority of respondents were supportive of the need for external assurance on the quality accounts; however there were reservations in relation to the inclusion of a Directors’ Statement in the quality accounts in 2009/10 and the timescale for the delivery of the final private report. Some concerns were also raised that further clarification was required on the criteria to support the opinion on the arrangements in place to ensure the quality accounts are fairly stated (the arrangements opinion). Monitor has amended its guidance in light of these concerns.
Monitor business plan 2010-2011. This business plan for 2010-11 builds on Monitor’s corporate plan for 2009-2012. It refines Monitor’s overall goals and sets out a detailed agenda for the coming year.
Cases
Southall v General Medical Council [2010] EWCA Civ 407 (CA). The
court held that the General Medical Council's Fitness to Practise
Panel had provided inadequate reasons for their finding that a
consultant paediatrician was guilty of serious professional
misconduct where it was alleged that he had accused a mother of
drugging and murdering one of her children.
Consultations
Consultation on interim registration fees for
providers of adult social care and independent health care.
This consultation looks at the proposed fees scheme for independent
healthcare and adult social care providers who will be registered
under the Health and Social Care Act 2008 from 1 October 2010. The
consultation closes on 16 June 2010.
News
Appointment of new Chair of Monitor - the
Independent Regulator of NHS Foundation Trusts. The DH has
announced that Steve Bundred, Chief Executive of the Audit
Commission, has been appointed as the new Chair of Monitor. The
appointment is for a term of four years, from 1 May 2010 to 30
April 2014.
Second wave of NHS trusts registered under new
system for monitoring standards. The CQC has announced plans to
give a further 211 NHS trusts a licence to provide services under a
new, tougher system for regulating standards in the NHS. For 10 of
these trusts, registration will be conditional on further action
being taken to address concerns about the safety and quality of
care. The regulator will register the remaining 201 trusts without
conditions, but it stresses that no trust can be complacent and all
must ensure that standards are maintained at all times. This press
release contains a full list of trusts, including all mental health
and ambulance trusts.
Bevan Brittan Training
Regulation.
29 September 2010 : Location:
Kings Orchard, 1 Queens Street, Bristol BS2 0HQ
Regulation. 16 September 2010 : Location: Fleet Place House, 2 Fleet Place, Holborn Viaduct, London EC4M 7RF
Regulation. 14 September 2010 : Location: Interchange Place, Edmunds Street, Birmingham B2 2TA
If you wish to discuss any of the items raised in this section please contact Neil Grant.
General
Publications/Guidance
Mutual benefit: giving people power over public
services. In this report, the Government sets out how it will
accelerate opportunities for mutuals to develop and flourish across
three key areas of public services, including health care.
Requested allocation of a deceased donor organ. This framework document provides advice about the circumstances in which a request for an allocation of a deceased donor organ to a close relative or friend could be considered in exceptional circumstances and when the needs of other patients should take precedence over that request for the allocation. It outlines a change to allocation policy which must be implemented consistently across the whole of the UK and must comply with law including the Human Tissue Act 2004 and the Human Tissue (Scotland) Act 2006.
Healthcare for single homeless people. This paper presents the results of analysis aimed at better understanding the health needs and relative healthcare costs of people who are homeless or living in certain types of insecure or short-term accommodation. Different models for provision of primary care services to this client group are discussed and the barriers experienced in accessing mainstream primary care are set out. Four models of care are described, ranging from outreach services to a fully integrated primary and secondary care model. The current take-up of these models is discussed and ranges from one third of PCTs which provide no specialist homelessness primary care services to a group of PCTs which provide a specialist homelessness primary care service with registration.
Cancer awareness: the impact of sexual
orientation. This report provides the results from a survey of
1600 heterosexual, gay, lesbian and bisexual respondents, using the
CR-UK Cancer Awareness Measure. The results highlight the
differences in cancer awareness between different sexual
orientation groups. The report will be of interest to people
involved in early diagnosis of cancer, researching, commissioning
or delivering interventions.
Valuing People Now delivery plan 2010-11. The
delivery plan for 2010-11 has been published together with a range
of materials to support the implementation of Valuing People Now,
the cross government strategy for people with learning
disabilities. The plan sets out the key priorities for 2010-11, in
particular, to improve employment and housing opportunities and
better health outcomes for people with learning disabilities and
their family carers.
Personalisation through person - centred
planning. This joint good practice guidance published by the
Putting People First and Valuing People Now teams has been
developed to help local areas understand how person-centred
planning can help to deliver Putting People First. It includes a
range of tools and good practice examples on person centred
planning and support planning to help give people more choice and
control over their lives.
NHS standard contracts. A number of additional documents and guidance to support the standard NHS contracts for acute hospital, mental health, community and ambulance services have been added to the DH website. They include Deeds of Variation and guidance to enable changes over to the new 2010/11 contracts. There is also a new standard contract for high secure services for use by the three Specialised Commissioning Groups responsible for commissioning high secure services to cover the services provided at Ashworth, Rampton and Broadmoor High Secure Hospitals, with guidance.
The DH has issued Pharmacy in England: building on strengths - delivering the future - Regulations under the Health Act 2009: pharmaceutical needs assessments. Information for primary care trusts that provides information to assist PCTs in publishing their pharmaceutical needs assessments. It explains and expands on the regulations.
Self-assessment management tool for delivery of information prescriptions. This self-assessment tool for managers covers the steps an organisation needs to take to provide information prescriptions, as well as helping to identify the organisational and workforce support needed.
Health Profile of England 2009. The Health Profile of England (HpoE) provides national and regional data, which local areas can compare against their own Health Profiles. There is a section of international comparisons. The HPoE is intended for public service professionals and officials within the local community. It outlines the areas which have shown recent improvements as well as areas where challenges remain.
The use of overseas doctors in providing
out-of-hours services. This report is an inquiry into the
arrangements for out-of-hours general practice.
A high-performing NHS? A review of progress 1997 -
2010. As the general election approaches, the NHS has emerged
as one of the most important issues for voters. Using official
data, government reports and academic research, this report
evaluates the NHS in England from 1997 to 2010.
Health priorities for an incoming government.
This report sets out the three areas that The King’s Fund believes
the new government should focus on. These are: responding to the
financial challenge facing the NHS, improving the quality of health
care, and promoting well-being and independence.
London Health Inequalities Strategy. Following
consultation, the Mayor has published his first Health Inequalities
Strategy. An accompanying 'action plan', First Steps to Delivery,
explains how the plan will be delivered.
General Election - 2010 guidance. Sir David
Nicholson, NHS Chief Executive, has sent a letter to Chief
Executives of NHS Trusts, SHAs and PCTs with information on conduct
and procedures during the General Election period. It includes an
updated guidance note for NHS organisations and advice on where to
direct further queries. The overarching principle is that NHS staff
should not be asked to engage in activities which are likely to
call into question the political impartiality of their organisation
or could give rise to criticism that public resources are being
used for party political purposes. it covers issues such as: public
appointments, consultations and stakeholder engagement, public
meetings, capital expenditure announcements, publicity, handling
information requests and external communications.
There is also similar guidance to Arm's Length Bodies Chief
Executives.
Fixing NHS IT: a plan of action for a new government. This report maps out an action plan for NHS IT to assist policy makers determine the way forward. It claims that the government could save £1bn by realigning the NHS IT programme and boosting its performance.
Cases
R (March) v Secretary of State for Health [2010]
EWHC 765 (Admin) (Admin Ct). The court held that the
Government's reason, articulated in answers given by the Secretary
of State for Health, for rejecting an independent inquiry's
recommendation that ex gratia payments to NHS patients treated with
contaminated blood should match the higher level of compensatory
payments made by the Irish government had contained a material
error of fact and the decision was quashed.
Legislation
National Health Service (Pharmaceutical Services
and Local Pharmaceutical Services) (Amendment) Regulations 2010 (SI
2010/914). These regulations, which come into force on 24 May
2010, make amendments to the framework Regulations which govern the
provision of NHS community pharmaceutical services. They give
effect to the provisions in the National Health Service Act 2006
which require PCTs to develop and publish pharmaceutical needs
assessments. The amendments also make some unrelated technical
changes to the framework Regulations, including correcting an error
which allowed a PCT, in certain circumstances, to grant dispensing
rights to a doctor when that surgery is within 1.6km of an existing
pharmacy.
News
New patient rights in force. Reports that from
1 April 2010, all NHS patients in England have new legal rights to
fast treatment, enshrined in the NHS Constitution. Patients have
the legal right to start treatment by a consultant within 18 weeks
of GP referral and to be seen by a specialist within two weeks of
an urgent GP referral for suspected cancer or, if this doesn’t
happen, and where patients request it, the NHS will be legally
obliged to take all reasonable steps to offer them a range of
alternative providers.
The NHS goes global. The DH has announced the launch of a new organisation, NHS Global, that will help NHS organisations to make the most of the global opportunities on offer. The total global market for healthcare was around $4.1 trillion in 2007 and is growing at a significant rate. NHS Global will build on the success of organisations such as BBC Worldwide, which markets programmes abroad and invests money back into the BBC. Some NHS organisations are already sharing their expertise internationally, such as the NHS Institute and Moorfields Eye Hospital. The Department of Health has begun preliminary work with NHS organisations to bring products to market and will launch a call across the system for further ideas to be submitted for consideration by NHS Global. It will also consult with NHS staff and stakeholders on how to ensure that NHS Global maximises benefit for patients in the UK.
The Centre for Workforce Intelligence (CWI) is to be established
to aid social care and NHS bodies deliver more efficient and
patient-centred care by helping the bodies plan workforces around
changing resources, by reducing bureaucracy and moving as much
healthcare as possible from hospitals and into homes and
communities. The CWI will: encourage best practice in workforce
planning in NHS and social care services; provide research and
advice to NHS and social care planners, clinicians and
commissioners; ensure those involved in workforce planning
contribute to the collection of, and use, high quality data,
analysis and modelling; and attain awareness of labour market
issues that could have an impact on care pathways.
NHS continues strong performance. Announces the
publication of the Quarter 3 (October – December 2009) performance
report that shows that the NHS met a number of key commitments on
healthcare priorities at the end of last year, and continues to
demonstrate strong financial management.
Large variations in medical cover in hospitals at night. Research carried out by the Royal College of Physicians has identified large variations in the provision of medical cover at night, with some doctors being responsible for up to 400 patients. The study, to be published later in the year in Clinical Medicine, examined the makeup of clinical teams in hospitals in England and Wales and the number of patients for which each team was responsible. It found that, at night, doctors were responsible for an average of 61 patients, but the range was from 1 to 400.
Bevan Brittan Training
Healthcare.
17 June 2010 : Location:
Interchange Place, Edmunds Street, Birmingham B2 2TA
What does the economy and the election mean for the NHS Estate - London. 11 May 2010 : Registration: 9.30am Seminar 10am - 12.30pm. Location: Fleet Place House, 2 Fleet Place, London EC4M 7RF
What does the economy and the election mean for the NHS Estate - Bristol. 13 May 2010 : Registration: 9.30am Seminar: 10am - 12.30pm. Location: Kings Orchard, 1 Queen Street, Bristol BS2 0HQ
What does the economy and the election mean for the NHS Estate - Birmingham. 19 May 2010 : Registration: 9.30am Seminar: 10am - 12.30pm. Location: Interchange Place, Edmund Street, Birmingham B3 2TA
