Legal intelligence for professionals in health and social care

This Update contains brief details of recent Government publications, legislation, cases and other developments relevant to those involved in health and social care work, which have been published in the last month.

If you have been forwarded this update by a colleague and would like to receive it directly, please email Claire Bentley.

  Care   Health and Safety
  Children   Information Law
  Clinical Management   Inquests
  Clinical Research   Mental Health
  Commissioning   Primary Care Trust
  Employment/HR    Prison Health
  Foundation Trusts   General




State of care 2009/10. The Care Quality Commission (CQC) has published a report on the state of healthcare and adult social care in England in 2009/10, based on findings from its regulatory, assessment and review work. It also includes four informal case studies in which it looks at different aspects of care. It highlights improvements in the care system but says there are still some areas which have not improved fast enough, and stresses that it is vital that the advances already made become a key component of the newly emerging care system. The report covers the services that CQC regulated and assessed under the previous legislation: the NHS and independent healthcare services; adult social care services; and councils and PCTs.

Safeguarding adults: The role of health services. The DH has launched four new sets of guidance to improve the care of vulnerable people in NHS funded care, covering the roles of health service practitioners, health service managers and their boards, and NHS Commissioners, and self-assessment and assurance framework for health care services. The documents remind staff and managers across the health service of the importance of personalised care and dignity and offer practical advice on how to deliver this. They assist NHS commissioners, health service managers and practitioners in preventing and responding to neglect and abuse, focusing on patients in the most vulnerable situations. The documents include good practice principles and examples.  

If you wish to discuss any of the items raised in this section please contact Carlton Sadler

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NHS at home: Children's community nursing services. This document shares the findings of a DH review of the contribution that community children's nursing services, as a key component of community children's services, can make to the future outcomes of integrated children's services.  

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

Staffing in maternity units: getting the right people in the right place at the right time. According to this report from The King’s Fund, using midwives and other maternity staff more effectively is the key to improving maternity care in hospitals. The report recommends deploying midwife-led care much more widely for women at a low and medium risk of problems, with the potential to improve outcomes for women and babies and to save costs to the NHS. It also suggests shifting tasks from doctors and midwives to nurses and support workers where appropriate could free up the time of midwives to provide one to one care for women and doctors to focus on supporting women at higher risk of problems. 

Bevan Brittan Events

Practical Approaches to Implementing Effective Obstetric Practices and Adopting Risk Management Strategies to Successfully Defend Negligence Claims. This is an external event hosted by C5, for more information, please visit www.C5-Online.com/obstetricPenelope Radcliffe from Bevan Brittan is one of the speakers at this conference and her session is on  "When do Obstetric Complications Lead to Successful Claims?"
If you wish to discuss any of the items raised in this section please contact Jackie Linehan

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Clinical Research

Healthcare Technology Co-operatives: filling a niche in the English R&D landscape. The purpose of this evaluation is to explore how the Health Technology Cooperatives (HTCs) initiative has affected relationships between clinical, industrial and academic partners; how the HTCs fit into the current health innovation landscape; and the alignment of HTC activities to the goals set out in the NIHR strategy.

£775 million investment for new NHS research in a major boost for patients and the economy. Announces funding over the next five years to NHS/university partnerships for translational research. Applications are encouraged to focus on improving health outcomes for patients in high priority disease areas such as dementia, cancer and heart disease.

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

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Practice-based commissioning: budget guidance for 2011/12 - Methodological changes and toolkit guide. PCTs are responsible for ensuring that practices receive an indicative budget that reflects the needs of their population as accurately as possible. This allows practices, emerging pathfinders and emerging consortia to access a 'fair share' of the resources available to the whole of the PCT for its patients. The DH has updated the toolkit that can be used to determine weighted capitation indicative budgets at sub-PCT level. The toolkit also provides information at practice level that may be useful for emerging pathfinders and emerging consortia.  

If you require further information about any of the items raised in this section please contact David Owens.

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Hutton review of fair pay in the public sector: final report. This report makes recommendations for a new settlement for public sector leadership. Under this deal, senior public servants’ pay will be directly linked to their performance and will be explained transparently to the public. In return, public service leaders are entitled to expect improved public appreciation of the responsibilities of senior public service roles, and the ethos of public service that motivates them.

Bevan Brittan Updates
Domesticating Dads. The Additional Paternity Leave Regulations 2010 came into force last summer and apply to parents of babies born or due (or due to be adopted) on or after 3 April 2011.  This is now only days away, and the babies in question are much more than a twinkle in their parents’ eyes.  Alastair Currie summaries the provisions and considers the practical implications for employers.

Employment news round-up - March 2011. Employment news items of interest, reported this month by Mike Smith, are: important dates for your diaries in April; changes to the specific public sector equality duty; the proposals for public sector pension reform; and avoiding possible ‘double payment’ of maternity pay. We also report on the immediate withdrawal of the local authority Two-tier Code and the publication of the Bribery Act guidance.

Unappealing employees. When is an employer entitled to treat an unappealed final written warning as final?  Sarah Michael looks at a recent decision of the Employment Appeal Tribunal which provides important practical guidance on how employers should deal with warnings, prior to dismissal. 

Fair Deal pension guidance. Following on from the commitment made in the Spending Review 2010 and the recommendations of Lord Hutton in the interim report from the Independent Public Service Pensions Commissions (IPSPC), the government has today announced a consultation on the future of the Fair Deal pension policy.

If you wish to discuss any of the items raised in this section please contact David Widdowson,  Julian Hoskins or Sarah Michael.

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Foundation Trusts

Producing quality reports. This Audit Commission briefing summarises the findings from the Audit Practice reviews of quality reports at 52 (out of 115) foundation trusts in Summer 2010. It aims to help FTs improve quality reports and the arrangements that underpin their production. Auditors found examples of good practice in foundation trusts, some of which are included in the briefing, but also found that there are four key improvement areas.

Contract dispute resolution: advice for NHS foundation trusts. This advice summarises the dispute resolution procedure for NHS foundation trusts and includes a summary of the three stages of the formal contract dispute resolution process.

Restructuring costs/revenue recognition. Guidance for foundation trusts on issues regarding recognition of revenue and restructuring costs. 

If you require further information about any of the items raised in this section please contact David Owens.

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Quality governance in the NHS - A guide for provider boards. The provider board is responsible for overseeing the quality of care being delivered across all services within the organisation and assuring itself that quality and good health outcomes are being achieved throughout the organisation. Effective governance therefore requires that boards pay as much attention to quality of care as they do to management of finances. Past service failures have illuminated gaps in knowledge amongst board members and a lack of clarity as to what good governance for quality looks like. This guide seeks to provide that clarity and acts as a route map to support provider boards as they navigate the system and lead their organisation in delivering improved quality and outcomes. It considers how to govern for quality, both in terms of driving continuous improvement across the organisation and ensuring that the essential levels of quality and safety are met. It recognises that processes and structures are vital in governing for quality, but also that values and behaviours are essential to a culture that supports quality. 

House of Commons Health Committee: Commissioning: further issues - Fifth Report of Session 2010-11. This report scrutinises the Government's proposed health reforms and recommends a number of significant changes to the Health and Social Care Bill. The committee considers that it is crucial to get the reform of NHS commissioning right if the service is to confront the massive financial challenge it now faces. Their report contains a set of practical proposals to strengthen the Health and Social Care Bill and make it better able to meet the Government's objectives. Their proposals are designed to ensure that NHS Commissioning involves all stakeholders – not only GPs but also nurses, hospital doctors, and representatives of social care and local communities - as this broadening of the base for commissioning is vital in order to achieve the changes that are necessary to allow the NHS deliver properly coordinated healthcare.

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

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Health and Safety

Saving mothers' lives: reviewing maternal deaths to make motherhood safer: 2006-2008. This report finds that the overall number of maternal deaths in the UK has fallen over the last three years despite a rise in the number of women dying from infection. For the first time there has been a reduction in the inequalities gap, with a significant decrease in maternal mortality rates among those living in the most deprived areas and those in the lowest socio-economic group. In addition an aide-memoire for healthcare professionals has been produced. The new chapter ‘Back to basics’, provides a list for the identification and management of the most commonly occurring conditions in pregnancy.

Learning report: Safer Patients Initiative. This report draws on the independent evaluation and case studies from those involved in the programme and from a five-year research programme which ran alongside the Safer Patients Initiative - Journey to Safety - carried out by Imperial College London. It provides an overview of the Safer Patients Initiative and its evaluation, and highlights the impact of the programme, key lessons and further issues for exploration. This report is published alongside separate evaluations for Phase 1 and Phase 2 of the project.

Maintaining and improving quality during the transition: safety, effectiveness, experience. This report is the first in a two-phase review about maintaining and improving quality during the transition and beyond. Building on the February 2010 Review of Early Warning Systems in the NHS, it emphasises how quality must remain the guiding principle as organisations move to implement NHS modernisation, and is clear that healthcare professionals are ultimately responsible for the quality of care provided to patients. Focusing on 2011/12, it describes the key roles and responsibilities for maintaining and improving quality, suggests practical steps to safeguard quality during the transition, and emphasises the importance of the effective handover of knowledge and intelligence on quality between old and new organisations.

Good management practice: guidance for all doctors. The General Medical Council has issued a consultation on the revised draft of the guidance on workplace issues faced by doctors. It looks at the steps that doctors should take when faced with a conflict between their management responsibilities and their duty to ensure patients receive good, safe care. The consultation closes on 3 June 2011.  

Bevan Brittan Updates
NHS Trusts: corporate manslaughter. Many will remember the discussions that took place a couple of years and more ago now, with the introduction of the Corporate Manslaughter and Corporate Homicide Act 2007 (the Act). Whereas previously, proof was needed that a “directing mind” of an organisation was personally guilty of manslaughter, now an organisation will be guilty of an offence if Senior Managers, manage it’s activities in a way that causes a person’s death and amounts to a gross breach of a relevant duty of care. By focusing more on the collective actions of senior management, the Act ultimately makes it easier to prosecute organisations.

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Information Law

The good practice guidelines for GP electronic patient records: version 4 (2011). This document will act as a reference source of information for all those involved in developing, deploying and using general practice IT systems. These latest guidelines supersede version 3.1, published in 2005.

Bevan Brittan Updates
Whose copyright is it anyway? Whenever your organisation puts together a new report, training DVD, glossy brochure or a website, the artistic, written and music components of that work will be protected by copyright. In the UK, copyright protection arises automatically so there’s no need for a formal registration process. It’s a valuable right because the law allows the owner of the work to generate income from it by licensing the work to others as well as preventing others from copying it. 

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

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Summary of reports and responses under Rule 43 of the Coroners Rules. Coroners' reports and responses received from organisations asked to consider action to prevent future deaths during the period between 1 April and 30 September 2010. This publication includes trends and reports with wider implications and annexes giving details of the numbers of reports issued by each coroner district, organisations who have neither responded to the coroner nor been granted an extention and all reports issued in this period.

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

Good Practice Procedure Guide: The transfer and remission of adult prisoners under s47 and s48 of the Mental Health Act. This guidance sets out the process for both the transfer to secure inpatient treatment and where appropriate, remission to prison, for Immigration Act detainees to and from inpatient treatment under the Mental Health Act.

Dementia care in London. Providing high-quality care and support for the increasing numbers of people with dementia is one of the most challenging and complex issues of our time. The number of people with dementia is set to double to 1.4 million in the next 30 years and the costs are expected to treble. This briefing identifies areas of unmet need, highlights problems with current provision, and draws attention to models of best practice.

The operation of the Deprivation of Liberty Safeguards in England 2009-10. This is CQC's first monitoring report on the implementation of the DOLS that protect the rights of people in care homes and hospitals who lack the mental capacity to consent to their care or treatment.

The route to success in end of life care: achieving quality for people with learning disabilities. This publication aims to provide a practical guide which supports anyone caring for people with learning disabilities to ensure that those who may be in the last months of their life receive high quality end of life care. It may also be useful to health or social care professionals who come into contact with people with learning disabilities in clarifying what measures need to be taken to ensure that they can access appropriate care. 

Predictive risk and health care: an overview. This report explores how predictive risk adjustment techniques are currently being used in the NHS and identifies some of the challenges involved in applying the techniques in practice. It also looks at emerging developments, including modelling with social care data, predicting the impact of preventive care and making shorter-term predictions of readmissions.

The European dementia research agenda. This report reveals that the dementia research agenda in most EU countries remains critically under-funded and under-valued and finds that there is widespread disparity in the diagnosis, treatment and care of people with dementia across Europe.

Public mental health and well-being: the local perspective. This report examines local leaders’ perceptions of public mental health and well-being, the progress they have made, how they are acting on recent evidence, and the complementary nature of addressing mental illness and improving mental well-being. It aims to describe the current state of public mental health and well-being and to provide a sense of what would help to take this work forward locally and nationally.

National Perinatal Mental Health Project Report: Perinatal mental health of black and minority ethnic women - A review of current provision in England, Scotland and Wales. The remit of this report and related studies is to facilitate a better understanding of how, and to what extent current and planned perinatal provision is capable of meeting the needs of BME women.

Safeguarding adults: The role of health services. These documents remind health services of their duties to safeguard adults. They assist NHS commissioners, health service managers and practitioners in preventing and responding to neglect and abuse, focusing on patients in the most vulnerable situations. The documents include good practice principles and examples.

Public mental health and well-being – the local perspective. This report by the NHS confed examines local leaders’ perceptions of public mental health and well-being, the progress they have made, how they are acting on recent evidence, and the complementary nature of addressing mental illness and improving mental well-being. It aims to describe the current state of public mental health and well-being and to provide a sense of what would help to take this work forward locally and nationally.

Accessible mental health services for deaf people. The aim of this briefing paper from the NMHDU is to provide information about practical things to consider when working with a Deaf person

Positive Practice, Positive Outcomes: A handbook for professional in the criminal justice system working with offenders with a learning disability. A best practice handbook from Offender Health and Valuing People providing information, practical advice, sign-posting and best practice examples for criminal justice professionals working with offenders with learning disabilities and learning difficulties. A booklet for offenders with a learning disability is also available (in easy read format) providing useful information about Positive Practice Positive Outcomes and information about the Criminal Justice System.

Facing up to the challenge of personal health budgets: the view of frontline professionals. This report examines attitudes and motivations to personal health budgets amongst frontline professionals working with mental health service users. These are based on research findings from 60 in-depth, qualitative interviews and a national quantitative survey amongst 645 respondents. It outlines the key challenges involved if frontline professionals are to effectively put into practice the theoretical principles behind personal health budgets. It draws attention to the complex nature of the main barriers involved, as well outlining how professionals might best be supported if these barriers are to be overcome.

Quarterly analysis of Mental Capacity Act 2005, Deprivation of Liberty Safeguards Assessments (England) Quarter 3 2010/11. Key facts noted are:-

  • The number of authorisations completed was 2,267 in quarter 3.
  • Of the total assessments completed in this quarter, a higher proportion were for females than for males.
  • In quarter 3, 74 per cent of assessments were made by local authorities while the rest were made by primary care trusts.
  • The percentage of authorisations granted which led to someone being deprived of their liberty was 54 per cent in quarter 3.

At 31 December 2010 1,450 people were subject to such authorisations

Patients’ experiences of the First-tier Tribunal (Mental Health). Key points in the report are noted as:
This report breaks new ground in accessing and communicating patients’ direct views on the tribunal system.
It is both possible and worthwhile collecting user feedback from detained patients about tribunals. 
Patients’ experiences of tribunals were diverse, ranging from positive to strongly negative. 
Those who received a positive outcome were, not surprisingly, much more positive of the system than those who received a negative outcome. 
Patients are not always well placed to ensure their lawyers are providing a good standard of advice and representation. 
Delays are a substantial factor in many patients’ negative experiences of tribunals.
 A large part of the distress caused by delays was due to a lack of information about timescales. 
The way pre-hearing medical examinations are carried out is very variable. 
Patients had positive experiences of some parts of the tribunal hearing, but there were concerns about the provision of information and access to reports. 
A significant minority said they were not given enough opportunity to be heard. 
Nearly all said they received a very rapid decision. However, follow-up information was lacking and patients felt poorly informed of any further right to appeal.

Summary of two cases on the meaning of deprivation of liberty: the "MIG and MEG" case and the "A and C" case. Two recent decisions examine when a person is deprived of their liberty. The first decision involved 2 girls of 18 (MIG) and 17 (MEG) with middle to severe learning disorders. The other involves 2 cases heard together – the first a child A, the second a young adult C – both living at home with one or both parents, and suffering from Smith Magenis Syndrome. In all 3 cases, the persons required a high degree of care and support, involving a degree of restraint which might amount to a deprivation of liberty. Both decisions however decided there had not been a deprivation of liberty.

Suicide Risk Management in Early Intervention. This guidance has been developed by the NMHDU Early Intervention in Psychosis programme and its aim is to provide practical guidance for practitioners, managers and clinical leads for managing suicide risk during a first episode of psychosis. It draws on current evidence for best practice in suicide prevention, informed by the expertise of the authors, Paddy Power and Moggie McGowan. It acknowledges the difficulties we face in identifying those who pose the greatest risk, but promotes an optimistic, practical and purposeful approach to management.

R (Faulkner) v SSJ (2011) EWCA Civ 349. The Claimant was awarded a figure of £10,000 "to reflect the loss of some 10 months' conditional liberty by reason of the state's breach of the claimant's right not to continue to be detained in the absence of a speedy decision by a judicial body. We have not arrived at it by applying a multiplier to a monthly sum, although it can no doubt be disaggregated in that way. It is in our judgment the nearest one can come to quantifying just satisfaction in monetary terms for this particular wrong."

R (W) v LB Croydon (2011) EWHC 696 (Admin). Croydon Council decided to transfer the claimant from residential placement to supported living on grounds of costs and to promote independence . The claimants mother challenged the decision on the grounds that there was no adequate consultation with the claimants parents and the residential facility. The court held that the consultation was not sufficient to be lawful and the decision was quashed.

Bevan Brittan Updates
Mental Health Patient to have a public Tribunal hearing. To date mental health tribunal hearings in England have been held in private. Claire Bentley and Simon Lindsay report on the landmark decision allowing a mental health patient to have a public hearing of his application for discharge from hospital with members of the press and the public present.

Courts clarify who is the Responsible Authority for the purposes of s.117 Aftercare under the Mental Health Act 1983. On 15 February 2011, the Court of Appeal provided clarity as to who the responsible authorities are for the purpose of s.117 aftercare under the Mental Health Act 1983 in the case of R (Hertfordshire CC) v Hammersmith & Fulham LBC and JM [2011] EWCA Civ 77. 

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

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Primary Care

The functions of GP commissioning consortia: a working document. This document describes the proposed statutory functions of GP consortia. It has been developed in partnership with the Royal College of General Practitioners, NHS Alliance, National Association of Primary Care, Family Doctor Association and PCT network of the NHS Confederation. It sets out: the proposed key statutory duties of consortia (the 'must dos'); the proposed key statutory powers (the things consortia have the freedom to do, if they wish, to help meet these duties); and illustrative examples of what this could look like in the future.

A shared agenda in the new world: the role of GP consortia and public health in improving health and wellbeing and delivering effective health care. This publication shares the findings from a national summit exploring the relationship between GP consortia and public health, and their shared role in improving health and wellbeing. The report claims that GPs lack clarity and understanding of how the new public health systems – health improvement, health protection, health services – will come together under the reformed NHS.

Primary care? An audit of the experience in primary care of rarer cancer patients. A survey of patients diagnosed with rarer cancers has shown that although many receive an excellent service in primary care, leading to a prompt diagnosis, others are having the signs and symptoms of their cancer missed.

NHS reforms in England: managing the transition. This briefing calls for early development of clear guidance on the governance and structural arrangements for emerging GP consortia, to ensure adequate local and national accountability for quality, financial control and value for money. The authors stress that the role of PCT clusters will be critical and extensive – if they are to retain staff and effectiveness they will need support, more clarity as to their priorities, and assurance of a future beyond 2013. They also call for more support for PCT clusters and shadow GP consortia in handling the essential reconfiguration of services, in particular with regard to hospitals.

Lighting the path: guidance for developing consortia. This guidance provides GPs and GP commissioners with some of the tools needed to develop consortia in London. The guide includes information on functions and responsibilities, elections, training, staffing and the need to seek legal advice.

Improving the quality of care in general practice: report of an independent inquiry commissioned by The King's Fund. This inquiry has concluded that, while the majority of care provided is good, there are widespread variations in performance and gaps in the quality of care delivered by general practice. The report endorses the principle that GPs should be generalists rather than specialists. However, with GPs set to be handed £80 billion of public money and a central role in implementing the government’s health reforms, it calls on general practice to embrace radical change if it is to maintain its international reputation for excellence. It also highlights evidence of variations in the quality of clinical care.

R (C) v Berkshire West Primary Care Trust; Equality and Human Rights Commission (Intervener) [2011] EWCA Civ 237 (CA). The court held that under the terms of its gender dysphoria policy, a PCT had been entitled to refuse to fund breast augmentation surgery for a transfemale on the basis that there was limited evidence that it would provide a clinical benefit.

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

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Prison Health

Positive practice, positive outcomes: a handbook for professional in the criminal justice system working with offenders with a learning disability. This best practice handbook aims to provide information, practical advice, sign-posting and best practice examples for criminal justice professionals working with offenders with learning disabilities and learning difficulties.

Good Practice Procedure Guide: The transfer and remission of adult prisoners under s47 and s48 of the Mental Health Act. This guidance sets out the process for both the transfer to secure inpatient treatment and where appropriate, remission to prison, for Immigration Act detainees to and from inpatient treatment under the Mental Health Act.

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

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Reforming Civil Litigation Funding and Costs in England and Wales - Implementation of Lord Justice Jackson's Recommendations: The Government Response. This Ministry of Justice Command Paper sets out the Government's response to "Proposals for Reform of Civil Litigation Funding and Costs in England and Wales - Implementation of Lord Justice Jackson's Recommendations".

Management of NHS hospital productivity. This report analyses the performance of the NHS over the past ten years, noting that whilst there have been improvements in the NHS, productivity has fallen. The report makes recommendations towards driving up productivity during the transition phase of the NHS reforms.

The NHS Standard Contracts for Acute Hospital, Mental Health, Community and Ambulance Services and supporting Guidance: 2011-12 - Effective from 1 April 2011. This page gives details of the NHS standard contracts for 2011/12 that apply to all new agreements from 1 April 2011. They should be read in conjunction with the Principles and Rules of Co-operation and Competition (2010) and the PCT Procurement Guide. The web page has been updated to include an Annex to the 2010/11 contract guidance and Deeds of Variation.

An evaluation of the impact of community-based interventions on hospital use: a case study of eight Partnership for Older People Projects (POPP). To improve the quality of care and at the same time reduce costs, efforts are being made across the UK to deliver more health and social care in community settings. One recent initiative to address this issue was the Partnership for Older People Projects – a series of innovative projects that received ring-fenced funding from the Department of Health over a two-year period. This report evaluates the project and will be of interest to health and social care policy-makers, senior managers and practitioners, and others involved in commissioning, as well as academics and students in the fields of health care and social policy.

Closing the gap: changing relationships. This booklet outlines eight project summaries which are part of the Closing the Gap: Changing Relationships programme. This improvement programme is dedicated to bridging the gap between best practice and routine delivery of care, by transforming relationships between people and health services.

The Quarter, quarter 3 2010/11. David Flory’s report for the third quarter of 2010/11 provides a summary of the NHS financial position and performance against the national priorities set out in the Revision to the Operating Framework for the NHS in England 2010/11. It shows that the NHS is continuing to provide improvements in the quality of patient care and robust financial management while preparing to transition to a health service more focused on improving patient outcomes.

The Cancer Drugs Fund: Guidance to support operation of the Cancer Drugs Fund in 2011-12. The guidance is therefore intended primarily for SHAs and their clinically-led panels. It builds on experience in 2010-11 of operating the regional arrangements for providing additional cancer drugs and is issued following feedback to the DH following consultation. Arrangements from 1 April 2012 and beyond will be the subject of discussions between the DH and the shadow NHS Commissioning Board. This guidance comes into force on 1 April 2011. It does not apply retrospectively. It will be kept under review and updated as appropriate during 2011-12.

Jones v Kaney (2011) UKSC 13. This decision means that expert witnesses have lost their immunity from being sued over matters arising in the course of proceedings. By a majority of five to two, the Supreme Court removed the 400-year-old protection that gave expert witnesses immunity from suit for breach of duty whether in contract or negligence, in relation to their participation in legal proceedings.

Solving disputes in the county courts. The consultation 'Solving disputes in the county courts: creating a simpler, quicker and more proportionate system' sets out, and seeks views on, proposals to reform the civil justice system in the courts in England and Wales. This consultation is aimed at the public, at business, and all those who have an interest in the civil justice system in England and Wales.

Access to the NHS by foreign nationals – Government response to the consultation. Sets out the Government’s response to the February 2010 consultation "Review of Access to the NHS by Foreign Nationals", outlining minor changes to the Charging Regulations and opportunities for collecting debts to the NHS by refusing visas to NHS debtors. The document also announces a wide-ranging review of free access to the NHS.

Personal Injuries (NHS Charges) (Amounts) Amendment Regulations 2011 (SI 2011/520). These regulations amend the 2007 Regulations (SI 2007/115) so as to increase the charges recovered from persons who pay compensation in cases where an injured person receives NHS hospital treatment or ambulance services. The increased charges apply to all injuries which occur on or after 1 April 2011.

Doctors 'want halt to NHS plans but reject opposition'. Doctors have called on the Government to put a halt to its overhaul of the NHS in England, but have stopped short of opposing the plans outright. Instead, an emergency meeting of the British Medical Association urged ministers to withdraw the Health Bill so the plans could be looked at again. The emergency meeting, the first of its kind for nearly 20 years, was called by the BMA leadership after concerns from its grassroots membership about the plans. The motion voted in favour of by delegates says withdrawing the Health Bill is needed so that the controversial and more radical elements of the legislation can be considered again. But a motion calling for outright opposition of the plans was narrowly rejected, while delegates also voted against a motion of no confidence in Health Secretary Andrew Lansley.

First woman appointed as Chief Medical Officer for England. The DH has announced that Dame Sally Davies has been appointed England's Chief Medical Officer.

New indicators for asthma, cardiovascular disease, obesity and smoking could be added to the 2012/13 Quality and Outcomes Framework (QOF), as NICE opens its consultation on potential indicators.

Increase in NHS prescription charges. This letter gives information on the increase in NHS prescription charges from April 2011.

OFT confirms scope of private healthcare study. The Office of Fair Trading has formally launched a market study into private healthcare, following a consultation on its scope. The study will focus on: the nature of competition in private healthcare provision; concentration of provision; barriers to entry; the role of consultants; and constraints on consumers. The OFT expects to issue a progress report in late summer before publishing its final market study by the end of 2011.  

Bevan Brittan Updates
How to buy, what to buy – Revising the EU public procurement rules. The European Commission has issued a Green Paper (which can be viewed here) seeking views on the way in which the current EU procurement rules could be revised. Key themes include exploring ways to reduce the current complexities of the procurement rules, increasing cross border trade, achieving environmental and social policy objectives through procurement and improving access for SMEs to public contracts.

Local Authority Two Tier Code to be withdrawn. In a speech to the CBI, Communities Secretary, Eric Pickles has announced that the local authority two-tier code, ‘the Code of Practice on Workforce Matters in Local Authority Service Contracts’  (‘the Code’) is to be withdrawn. This development was widely anticipated following the withdrawal of the general public sector two-tier code last December.  The withdrawal of the Code will have a major impact on local authority employers, but will also affect other public and private sector organisations involved in joint working arrangements with local authorities.

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

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