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   Inquests
  Children   Mental Health
  Clinical Management   Obesity
  Commissioning   Primary Care
  Employment/HR   Prison Health
  Estates and facilities   Regulation
  Finance   General
  Foundation Trusts

 

Care

Publications/Guidance
Achieving closure: good practice in supporting older people during residential care closures. This good practice guide, commissioned by the Association of Directors of Adult Social Services (ADASS), is aimed at helping local councils re-assess and re-settle older people in care homes when they close. The guide stresses the importance of not making rushed decisions, offers practical advice on managing closures and provides a series of helpful checklists. 

Improving value for money in adult social care. This paper is the first in a series of briefings which will examine value for money in health and social care. This briefing finds that better procurement, improved back office arrangements, and a preference for community-based rather than residential care where possible, are just some of the changes that local authorities have implemented to help them meet the challenges they face. It also highlights the need for increased pace and scale of change in order to improve services for users.

Dignity and nutrition for older people - reports. The Care Quality Commission has published the first 12 reports from an inspection programme which examines whether elderly people receive essential standards of care in 100 NHS hospitals throughout England. The programme focuses on whether people are treated with dignity and respect, and whether they get food and drink that meets their needs. A national report into the findings of the programme will be published in September. These first 12 inspection reports identify three hospitals as failing to meet the essential standards required by law. Less serious concerns were identified in a further three hospitals, with the remaining six found to be meeting essential standards.

Care in crisis: causes and solutions. This report from AGE UK presents the results of an investigation into the care system in England. It finds that 800,000 people who currently need care receive no formal support from either the state or private sector agencies. The report makes recommendations for the future of the social care system and the funding and provision of it.

The end of life care patient charter. This charter for end of life care that sets out best practice standards that all patients deserve from their primary health care team. It makes seven pledges to patients and their families. The pledges aim to help them live as well as they can, for as long as they can. The charter is the result of collaborative work between patients, nurses, GPs, specialists and others from health and social care, and it will be revised over time based on feedback from patients, carers and primary health care teams.

Draft spiritual support and bereavement care quality markers and measures for end of life care. These draft quality markers and associated measures follow the same pattern as for the established quality markers. The content has been drafted on the basis of specially commissioned literature reviews and with the help of expert working groups.

Local health profiles 2011. This statistical release draws together information to present a picture of health in each local area. There are 351 Local Health Profiles – one for each Lower Tier, Upper Tier, Unitary and Metropolitan District Authority in England. They are a valuable tool for local government and health services in helping them to understand their community’s needs, so that they can work to improve people’s health and reduce health inequalities.

Dignity in Practice - An Exploration of the Care of Older Adults in Acute NHS Trusts. The aim of this study by the British Geriatrics Society is to look at evidence-based guidance for policies and practice to promote dignified care.

A quest for quality in care homes. The report by the British Geriatrics Society reviews current NHS support for care homes. It describes what should and could be done and calls for national action by government and local action by NHS commissioners, planners and clinical services to improve the quality of NHS support to care homes. It highlights the need to build joint professional leadership from the health, social, and care home sectors, statutory regulators and patient advocacy groups to find solutions.

Making care safer. This report by the Health Foundation collects together the testimony given by family and carers of people living in a care home, specifically around issues of medication safety. Three day-long focus groups were held in 2010, in Manchester, Birmingham and London. The issues and potential solutions raised by the groups are presented in this report under four main headings: communication and information sharing; prescribing and administration of medication; staff development and support; and advocacy and rights. 

Fairer care funding. The Commission on Funding of Care and Support, chaired by Andrew Dilnot, has published its final report on changes to the funding of adult social care in England. It recommends that costs should be capped and the means-tested threshold increased. Instead of individuals paying all their care costs until they have assets of less than £23,250, as under the current system, the proposals would mean that those with high care costs would only pay up to a set amount and after that their care costs would be paid for by the State. The Commission estimates that its proposals, based on a cap of £35,000, would cost the State around £1.7bn.
Among the recommendations in the report are:
 individuals’ lifetime contributions towards their social care costs – which are currently potentially unlimited – should be capped. After the cap is reached, individuals would be eligible for full state support. This cap should be between £25,000 and £50,000. We consider that £35,000 is the most appropriate and fair figure;
 the means-tested threshold, above which people are liable for their full care costs, should be increased from £23,250 to £100,000;
 national eligibility criteria and portable assessments should be introduced to ensure greater consistency;
 all those who enter adulthood with a care and support need should be eligible for free state support immediately rather than being subjected to a means test;
 a new universal deferred payment scheme for anyone who would be unable to afford care charges without selling their home. Local authorities should be allowed to charge interest to recover their costs, to make the scheme cost neutral, and to remove the disincentive they currently face in promoting the scheme;
 new social care legislation should place duties on local authorities to provide information, advice and assistance services in their area, and to stimulate and shape the market for services;
 the Government should review the scope for improving the integration of adult social care with other services in the wider care and support system.

The Government has stated that it welcomes the report. It will consider each recommendation carefully to test whether it meets the wider objectives for reform, including increased personalisation, choice and quality, closer integration of health and social care and greater prevention and early intervention. The Government will need to consider the acknowledged significant costs of implementing the reforms against other calls on constrained resources. The Government wants to create a social care system that offers people and their carers choice and personalised, high quality care. It will be engaging with the care sector over the autumn to develop and refine its priorities and plans for action, bearing in mind the financial context.

News
Bristol City Council responsible for poor standard of care of an elderly woman in a care home. The Local Government Ombudsman has ordered Bristol City Council to pay £85,000 compensation to an elderly woman who was left in soiled bed sheets at a care home. The report found the council - which partly funded her placement - had failed to monitor the care being given. The authority said it accepted the findings and apologised to the family.

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

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Children

Publications/Guidance
The care of looked-after children in custody. This report gives information on the care of looked-after children aged 15 to 18 in young offender institutions. It examines the experience of these children, using survey data and in-depth interviews.

Adolescent health in the UK today: where next? This paper examines trends in adolescent health and looks at the main policy themes of the last decade as well as issues for service delivery relating to adolescent health.

The RCN's UK position on health visiting in the early years. The Royal College of Nursing has published evidence of the important role that health visitors play in the lives of children and families. The briefing provides evidence for health visiting as a means of improving public health in a challenging time for the NHS. The principles position statement sets out core values to guide the development of health visiting across the UK.

Evidence base for Family Nurse Partnership (FNP). The evidence base for FNP is robust with three high quality US trials showing a wide range of positive impacts for children and mothers over the short, medium and longer term. This summary leaflet provides more information on this evidence base.

Consultations
Child protection guidance. The GMC is consulting on new guidance to help doctors protect children. The consultation runs from 27 June to 14 October 2011.

News
Improving health services for vulnerable children and young people. Announces that responsibility for commissioning health services for children and young people in Secure Children’s Homes and Secure Training Centres is to pass to the NHS, bringing it into in line with that for Young Offender Institutions.

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

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Clinical Management

Publications/Guidance
Clinical Negligence Scheme for Trusts (CNST) cover for the management of clinical negligence risks of qualified independent sector providers of treatment delivered to NHS patients. This letter provides instruction on how the clinical negligence risks associated with NHS-commissioned elective activity undertaken by independent sector providers can be covered by the CNST when the Extended Choice Network/Free Choice Network contracts expire at the end of June 2011 and for independent sector treatment centre progression procurements planned or underway.

Does clinical coordination improve quality and save money? This report examines the evidence for the extent to which poor coordination contributes to poor quality outcomes for patients and the approaches to clinical coordination which are shown to improve care and whether these can reduce costs.

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

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Commissioning

Publications/Guidance
Government Response to the House of Commons Health Select Committee Fifth Report of Session 2010-11:Commissioning. The House of Commons Health Select Committee published a report on Commissioning under NHS Reforms on 5 April 2011. This Command Paper sets out the Government's response to the conclusions and recommendations in that report. 

Funding the right care and support for everyone. This report recommends the introduction of the first per-patient funding system for palliative care in the NHS. The proposals include the development of a palliative care tariff based on need, a funding system which incentivises good outcomes for patients, irrespective of time and setting, and providing incentives for commissioning integrated care packages which stimulate community services.

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

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Employment/HR

Publications/Guidance
DWP: Health, work and well-being - Attitudes of GPs, line managers and the general public. This research explored various audiences’ motivators and barriers to changing attitudes towards health and work to maintain a healthy workforce and aid return to work. It looked at what should be the key drivers for change.

New pay circular for medical and dental staff. The pay scales and allowances for medical and dental staff in England, effective from 1 April 2011, are now available in Pay Circular (M&D) 1/2011. It informs employers in the NHS (England) of the freeze in the national pay rates of hospital medical and dental staff, as well as doctors and dentists in public health, the community health service, salaried primary dental care and salaried general practitioners

Ensuring transparency and probity. The BMA's GPs Committee sets out how consortia can ensure their governance arrangements have the confidence and trust of the public. It also calls on the government to scrap the proposal to pay consortia a performance-related payment if they perform well financially.

A realistic review of clinico-managerial relationships in the NHS: 1991-2010. This report aims to synthesise research published in the 1990s and 2000s into a form that will be useful to managers, clinicians, academics and other stakeholders. It discusses how clinico-managerial relationships have changed over the last twenty years and considers which forms of development and training programmes might best support their improvement.

NHS staff attitudes tracking survey. This document provides the results of a survey into staff morale and engagement in the NHS. It also gives an overview of general attitudes towards a range of departmental and NHS initiatives.

Cases
Hosny v General Medical Council [2011] EWHC 1355 (Admin) (Admin Ct). The court held that there was more than sufficient strong circumstantial evidence to entitle the GMC's Fitness to Practise Panel to conclude that an anaesthetist wrote a false reference and sent it to locum agencies and, when completing job application forms, had failed to give notice of restrictions and conditions on her practice. In the light of that dishonesty, the Panel had rightly concluded that her fitness to practise was impaired and that the appropriate sanction was a 12-month suspension.

Bevan Brittan updates
Disciplinary proceedings: case round-up. Like buses, you wait ages for a key case on disciplinary procedures, and then two come along at once:  the EAT has recently considered the important (but sometimes very fine) distinction between a misconduct dismissal and dismissal for ‘some other substantial reason’; and, in a second case on a similar theme, the High Court has shed further light on the emerging principles around the application of the European Convention on Human Rights to disciplinary proceedings.   Sarah Michael reports.

Employment news round-up – June 2011 John Moore reports on the latest employment news: TUPE and collective agreements; amendments to the Agency Workers Regulations Guidance; details of a change in how employment tribunals allocate compensation between multiple respondents; and a research paper from Acas on how the new disciplinary and grievance procedures are bedding in.

Passive tense: when inaction makes things worse Inaction, or insufficient action, by an employer who is aware of the repeated racial harassment of an employee by a third party can lead to the employer being liable for that harassment, according to a recent decision of the EAT.  This case concerned the Race Relations Act, which has since been repealed, but the principles continue to be relevant – and will be particularly relevant for public sector employers whose employees are likely to come into contact with members of the public who engage in challenging behaviour.  Sarah Lamont looks at the detail. 

Dealing with strike action: a practical guide for employers The news that up to 750,000 public sector workers have agreed to commence strike action on 30 June 2011 is no surprise to many. The fifth largest trade union, the Public and Commercial Services Union has announced that 290,000 of its members intend to strike, which will affect a wide range of services. The National Union of Teachers and the Association of Teachers and Lecturers has also voted for strike action to protect teachers’ pensions. The strike action will purposely coincide with the other public sector strikes due to take place on 30 June 2011.

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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Estates and facilities

Publications/Guidance
Strategic Health Authorities Estates capabilities. This letter from Director of Gateway Review and Estates & Facilities Division Professor Rob Smith identifies the range of areas where work programmes will require estates and property capability in order for authorities to discharge their responsibilities.

Legislation
NHS Foundation Trusts and Primary Care Trusts (Transfer of Trust Property) Order 2011 (SI 2011/1552). This Order, which comes into force on 20 July 2011, transfers property held on trust (charitable property) from the NHS Foundations Trusts and PCTs to other NHS bodies, following the transfer of services from the PCT to the NHS body under the Transforming Community Services programme. Order transfers the funds from the body currently holding the funds to the body that will then be the corporate trustees for them. Copies of the schedules of trust property transferred under this Order can be obtained from the Department of Health.

If you require further information about any of the items raised in this section please contact  Rob Harrison or Mark Calverley..

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Finance

Publications/Guidance
Old and broke: The long term outlook for the UK's public finances. The report looks at the cost of future public spending in relation to the population of the UK. It reports that annual spending on the NHS will increase by nearly £40 billion by 2041. The report makes policy recommendations on pension reforms and NHS provision.

Funding the right care and support for everyone. This report recommends the introduction of the first per-patient funding system for palliative care in the NHS. The proposals include the development of a palliative care tariff based on need, a funding system which incentivises good outcomes for patients, irrespective of time and setting, and providing incentives for commissioning integrated care packages which stimulate community services.

Funding the right care and support for everyone. This report recommends the introduction of the first per-patient funding system for palliative care in the NHS. The proposals include the development of a palliative care tariff based on need, a funding system which incentivises good outcomes for patients, irrespective of time and setting, and providing incentives for commissioning integrated care packages which stimulate community services.

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


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Foundation Trusts

Publications/Guidance
Delivering an all-foundation trust provider landscape. This letter to NHS Trust Chairs from the DH's Managing Director of Provider Development, Ian Dalton, highlights the impact of issues raised in the NHS Future Forum report on the delivery of the Foundation Trust pipeline.

Survey of NHS foundation trust governors 2010/11. The objective of the survey was to understand how governors feel about their ability to perform their role, and to identify potential areas for improvement.

Current practice in NHS foundation trust member recruitment and engagement. This report outlines the progress that foundation trusts have made in membership recruitment and engagement.

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

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Inquests

Bevan Brittan updates
Avoiding a coroner's Rule 43 report at an inquestClaire Bentley and Debbie Platts look at the fourth summary of reports and responses under Rule 43 of the Coroners Rules published by the Ministry of Justice in March 2011.  It bears thorough reading as it makes clear the trends in reporting by Coroners and the issues requiring such reports.

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Mental Health

Publications/Guidance
QIPP and mental health: reducing the use of out of area services. This briefing provides a guide to help local mental health communities, from both the NHS and local authorities, gain a better understanding of their use of out of area services and, where appropriate, come up with solutions to provide better value for money. It gives an overview of the issue and describes a seven step approach to reducing use of out of area services where it is appropriate to do so.

Role of the Independent Mental Health Advocate (‘IMHA’) in First-tier Tribunal [Mental Health] Hearings. The Mental Health Tribunal have issued guidance on the role of Independent Mental Health Advocates (IMHAs) in Tribunals.

Update on Payment by Results (PbR) for mental health services for working age adults and older people. Letter from Bob Alexander, Director of NHS Finance, and Bruce Calderwood, Director of Mental Health Policy, with an update on the latest developments on PbR for mental health services for working age adults and older people, as well as confirming the timescales for its implementation.

Meeting the needs of health people with learning disabilities: RCN guidance for nursing staff. This is the updated second edition of this guidance which aims to support nurses and nursing students in delivering high quality care to those with learning disabilities. The guidance provides a definition of learning disabilities; outlines some specific health needs; and explains relevant legislation.

Common mental health disorders. This new NICE guideline on the identification of and pathways to care for common mental health disorders focuses on primary care. It draws on existing NICE guidelines and makes new recommendations on how patients are assessed, and when and how they are referred to other services for treatment. The guideline also provides advice to managers and commissioners on how to develop referral and care pathways in their local area.

National audit of dementia services - establishment of memory services. Professor Alistair Burns, National Clinical Director for Dementia, has written to colleagues asking for assistance with a national audit of dementia services, which includes looking at the provision of memory services. It is being undertaken by the NHS Information Centre.

NHS data gaps for learning disabilities. This report looks at the data collected by the NHS about the health and healthcare of people with learning disabilities and considers whether it is as good as it should be.

The National Confidential Inquiry into Suicide and Homicide by People with Mental Illness: Suicide and Homicide in Northern Ireland. Manchester University has published a report commissioned by the Department of Health, Social Services and Public Safety which presents findings and recommendations resulting from the National Confidential Inquiry into Suicide and Homicide by People with Mental Illness. The reports aims to improve understanding of the risks of suicide in people with mental illness and how to respond more effectively to those risks.

The Ministerial Advisory Group on Dementia Research has reported the findings of its 18-month work programme.
See also the DH press release More funding for dementia research that announces the launch of the "Route Map for Dementia Research" which pledges up to £20m from the DH over five years for four new National Institute for Health Research (NIHR) Biomedical Research Units and commits the Medical Research Council to increase funding for neurodegeneration research by 10% to £150m over the next four years to 2015. it also strengthens links between public and private research sectors to identify new opportunities for partnership, and ensures more patients and carers get involved in research through the NIHR’s Dementia and Neurodegenerative Diseases Research Network which will facilitate research in the NHS and care home sector.

Our Invisible Addicts. The report, written by the Older People’s Substance Misuse Working Group of the Royal College of Psychiatrists, warns that not enough is being done to tackle substance misuse in our aging population – making them society’s “invisible addicts”.

'I think I must have been born bad': Report by the Children's Commissioner on the emotional wellbeing and mental health of children and young people in the youth justice system.

Cases
Hillingdon LBC v Neary (by his litigation friend the Official Solicitor; Equality & Human Rights Commission (Interested Party) [2011] EWHC 1377 (COP) (CP). Bevan Brittan has issued an Alert on this case - see Good practice for local authorities and PCTs identified in the Steven Neary case.

Hadzic and Suljic v Bosnia and Herzegovina (2011) Application No.: 00039446/06 : 00033849/08. These applicants in two separate cases were convicted of manslaughter. As a result of their diminished responsibility at the time they were made subject of a hospital order. As an interim solution they were detained in a prison forensic psychiatric annex. This solution had become permanent. This was unlawful as the institution was not appropriate for mental health patients.

Consultations
Incapacitated person - A modern definition. This consultation published by HM Revenue & Customs closes on 16 August. It looks at how best to modernise the language used to define an incapacitated person for direct tax purposes.

Court of Protection: Authorised officers - A consultation on the delegation of some decisions in the Court of Protection to court officers. This consultation seeks views on the proposal that an amendment be made to the Court of Protection Rules to provide for authorised officers to deal with specified types of applications. Responses are requested from the public, the legal profession, the judiciary, the advice sector and all with an interest in England and Wales. The consultation closes on 20 September 2011.

Equality Impact Assessment of exclusive mental health legal services contracts in High Security Hospitals. The Legal Services Commission is seeking views on the equality impact assessment (EIA) of exclusive mental health legal services in high security hospitals. Comments by July 29, 2011.

News
Patients win smoking ban challenge. Reports that patients at Chadwick Lodge Hospital, Milton Keynes who have been sectioned under the Mental Health Act have won permission to bring a legal challenge over a smoking ban.

DH Review following events at Winterbourne View Hospital.

The Department of Health has published the terms of Reference for the DH Review of Events at Winterbourne View Private Hospital.  A criminal investigation is underway and there will also now be thorough reviews by other agencies into what happened at Winterbourne View.  The local council will lead an independently chaired Serious Case Review, involving the police, the NHS, the CQC and local authorities. CQC is carrying out its own internal investigation.

Bevan Brittan Updates
Identifying wrongful detention and what to do about it. A common problem for mental health managers who have uncovered a procedural irregularity in a patient’s detention is in working out whether this means that the patient should be discharged and/or compensated. This article considers the current legal position and three recent cases.

Safeguarding adults - Behind closed doors. In terms of guidance, the Department of Health's “No Secrets”  remains a valid document which sets out the range of  categories of abuse and some mapping of safeguarding procedures. However, the most recent guidance, “Safeguarding Adults -The Role of Health Service Practitioners”, issued in March 2011, is an important updating document that all health professionals should read.

Good practice for local authorities and PCTs identified in the Steven Neary case. Simon Lindsay reviews the case of Steven Neary and the essential practice points identified for PCTs and local authorities. 

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

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Obesity

Publications/Guidance
Obesity epidemic - paranoia or evidence-based? This report assesses current predictions indicating that 60% of the UK population will be classified as clinically obese by 2050 and recommends action to reduce this risk. 

If you would like more information about the portal please contact Julie Chappell.

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Primary Care

Publications/Guidance
Capitation and quality scheme statement of financial entitlements 2011. This SFE relates to the payments to be made by PCTs to dental pilot contractors. It introduces new payment mechanisms relating to the NHS (Dental Services) (Capitation and Quality Scheme Agreements) Directions 2011, which came into force on 1 June 2011. There is also supporting guidance.

Quality and Outcomes Framework (QOF) quality and productivity indicators: supplementary guidance and frequently asked questions for PCTs and practices in England. This guidance aims to assist PCTs and practices in understanding and working through the new quality and productivity indicators, building on the information in the 2011/12 QOF guidance.

Holding back the British IVF revolution? A report into NHS IVF provision in the UK today Following a number of Freedom of Information questions to all PCTs in the UK on provision of IVF treatment, this report highlights the inconsistent availability and variation in IVF provision.

Cases
Flasz v Havering PCT; Secretary of State for Health (Interested Party); Jan-Mohamed v Greenwich PCT; Secretary of State for Health (Interested Party) [2011] EWHC 1487 (Admin) (Admin Ct). The court held that s.94(2) of the National Health Service Act 2006 did not oblige the Secretary of State to give health authority bodies the right to withdraw from s.92 arrangements if they wished to do so. However, it did not prevent him from doing so. The National Health Service (Primary Medical Services) (Miscellaneous Amendments) Regulations 2010 were not ultra vires. The judgment confirms that PCTs retain their right to terminate the PMS contract with six months' notice and that PCTs have been acting within the legal framework.

Bevan Brittan Updates
Must “private life” factors be considered in the allocation of scarce resources? The High Court has recently ruled in favour of a Primary Care Trust in relation to a decision concerning the allocation of scarce resources in R (Condliff) v North Staffordshire PCT.  This article examines the case itself and provides some practical lessons to be learnt from it.

PMS contract termination clauses - court case. Last year Bevan Brittan wrote an article Sharper teeth for PMS commissioners which clarified the rights of PCTs to terminate PMS agreements on notice, ‘without fault’. This stemmed from amendments to the PMS Agreement Regulations which came into force on 1 April 2010. A recent judgment has now confirmed that PCTs retain their right to terminate the PMS contract with six months' notice and that PCTs have been acting within the legal framework.

Southern Cross Crisis - Implications for local authorities and PCTs Local authorities, and PCTs commissioning Continuing Health Care, will need to keep a close eye on developments at Southern Cross. As the Group provides care for in the region of 37,000 residents (approximately 31,000 in the elderly care category) across over 750 care homes, the uncertainty over its continuing trading is likely to impact upon the vast majority (if not all) of local authorities and PCTs. Exposure will be greater in some regions than others but, particularly with out of area placements, there are unlikely to be any commissioning authorities who are completely untouched by the events. For some, the crisis potentially jeopardises the placements of hundreds of vulnerable adults for whom they are responsible.

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

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Prison Health

Publications/Guidance
The care of looked-after children in custody. This report gives information on the care of looked-after children aged 15 to 18 in young offender institutions. It examines the experience of these children, using survey data and in-depth interviews.

Information needs of women in prison with mental health issues. Nacro was asked by Mind to investigate what information could usefully be provided for women in prison with mental health issues. 

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

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Regulation

Consultations
Registration of primary medical services providers by the Care Quality Commission: a consultation on a proposed change in the date of registration. All providers of ‘regulated activities’ in the field of health care and ‘adult social care’ are required to register with the Care Quality Commission (CQC). In order to be registered with the CQC providers are required to comply with a set of registration requirements that establishment essential levels of safety and quality. From April 2012, providers of primary medical services for the NHS are due to enter the registration system. This includes GP practices, out of hours providers of primary medical care services and NHS walk-in centres. This document describes proposals to change the start date for registration of GP practices to April 2013, while proposing that the registration of out of hours providers and NHS walk-in centres should still go ahead in April 2012. The consultation closes on 27 July 2011. 

News
Government announces extension of International Accounting Standard 27 to all NHS organisations. HM Treasury has announced that Monitor has agreed to extend the consolidation accounting standard to all NHS organisations from 1 April 2013. This application has been deferred since the adoption of International Financial Reporting Standards across central government on 1 April 2009. This decision will ensure that the highest standards apply to the reporting of public expenditure. The deferral will allow time to achieve consistent and correct application across the NHS. his deicsion does not affect NHS-linked charities - the regulation of charities remains a separate matter and the responsibility of the Charity Commission.  

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

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General

Publications/Guidance
Implementing the Overseas Visitors Hospital Charging Regulations 2011 (Regulations come into force from 1 August 2011). Guidance for NHS bodies in carrying out their duties under SI 2011/1556 to make and recover charges for NHS hospital treatment from overseas visitors not exempt from charge. It also includes guidance to safeguard the health of those not entitled to free hospital treatment.

A&E clinical quality indicators: best practice guidance for local publication. Sets out best practice guidance for the presentation and publication of the A&E clinical quality indicators. A&E sites following this guidance will ensure that locally published information on the indicators provides an accurate, transparent and comparable reflection of their performance.

Heatwave plan for England: protecting health and reducing harm from extreme heat and heatwaves. This plan has been re-issued as a part of raising both public and professional awareness. The plan's purpose is to enhance resilience in the event of a heatwave and is an important component of overall emergency planning.

Heatwave Plan 2011. This letter introduces the National Heatwave Plan for England for 2011. It gives information on the responsibilities of local authorities and PCTs.

CNST cover for the management of clinical negligence risks of qualified independent sector providers of treatment delivered to NHS patients. This letter provides instruction on how the clinical negligence risks associated with NHS-commissioned elective activity undertaken by independent sector providers can be covered by the CNST when the ECN/FCN contracts expire at the end of June 2011 and for ISTC progression procurements planned or underway.

Introduction of bar codes will save NHS millions. Announces that standard ‘GS-1’ bar codes on products will be used across the NHS making it easier to track and compare purchases. This also has great potential to improve patient safety - bar coding systems have been shown to reduce medication errors, the risk of wrong-site surgery and the effective tracking and tracing of surgical instruments, equipment and other devices to improve record keeping and reduce error, malfunction and contamination. The decision to invest in systems will sit with each Trust; the cost of investment will be covered by the savings made. DH will support the procurement of framework contract arrangements for system and service providers that will incorporate the required standards and specifications and lower the cost of entry for the NHS.

NHS Future Forum Recommendations to Government. Provides key recommendations to the Government on the future for NHS modernisation.
See also the Government response to the NHS Future Forum report that summaries the key changes the Government intends to make in response to the NHS Future Forum. The changes are largely structured around the four workstream themes considered by the NHS Future Forum. Some, but not all, of these changes require amendments to the Health and Social Care Bill.

Accountability in the NHS - Implications of the Government's reform programme. This report from think tank The King's Fund discusses the nature of accountability relationships in the NHS and how these will change under the reforms. The authors identify five types of accountability most relevant to health care – by scrutiny, management, regulation, contract and election. The report considers that there is a real risk that the accountability of secondary care providers will be underpowered in the new system. The authors contend that this may be politically unacceptable in the medium to long term. Overall, they raise concerns about a shift towards a reliance on local accountability mechanisms that are, as yet, unproven.

Seasonal flu plan: winter 2011/12. This plan sets out a coordinated and evidence based approach to planning for and responding to the demands of seasonal flu across England. It will provide the public and healthcare professionals with an overview of coordination of preparation for seasonal flu and signposts where further guidance and information can be found.

Overall Patient Experience Measure updated to include results from the 2010 Inpatient Survey. These statistics use responses that NHS patients gave in the wide-ranging national patient survey programme to calculate an overall set of scores to measure patient views on the care they receive. They include scores for five headline 'domains' of patient experience, together with an overall measure.

The voluntary and community sector in health: implications of the proposed NHS reforms. The voluntary and community sector in health: Implications of the proposed NHS reforms published by the Kings Fund considers the main opportunities and challenges facing the sector.

European report on preventing elder maltreatment. This report prepared by the WHO highlights the biological, social, cultural, economic and environmental factors that influence the risk of being a victim or perpetrator of elder maltreatment, as well as the protective factors that can help prevent it.

Informed consent in health and social care research. This document provides guidance for nurses undertaking research and who need to seek informed consent from patients for their work.

Health Committee - Sixth Report: Complaints and litigation. This report examines current NHS complaints and litigation procedures. It reports that although levels of satisfaction with the process were found, changes could still be made to improve patient experience. The report prepared by the Committee makes recommendations towards a full Government review of the complaints and litigation process and advises on the development of separate systems for handling customer care and clinical systems complaints.

2011 global survey of health care consumers. This annual survey by Deloitte assesses health care consumers behaviours, attitudes and unmet needs in order to quantify changes year by year.

Dignity and nutrition reports. The next batch of reports from the dignity and nutrition inspection programme have been published. This programme intends to look at 100 NHS trusts, and focuses on whether people are treated with dignity and respect and get food and drink that meets their needs.

Inquiry into the review of the Professional Qualifications Directive: Mobility of healthcare professionals. This response from the MPS focuses on the question of the practical impact of the proposals, particularly the availability of redress should patients suffer avoidable harm.  

Bevan Brittan Updates
NHS Future Forum report - Better late than never? We look at the NHS Future Forum's recommendations to Government on how the Health and Social Care Bill might be improved, following the "listening exercise". Given the resounding opposition from many at the frontline of health in relation to this controversial Bill, we have awaited the recommendations with interest to see whether they amount to a quick polish or a complete overhaul.

Reforming the reforms. Comment and detail on the amendments to the Health Bill.  Following the Future Forum report and the Government’s response we now have the amendments being proposed to the Health & Social Care Bill when it goes back into committee in the House of Commons. Obviously these are by no means the final word on the legislation, as it has yet to go through the House of Lords, but politically this represents the Coalition’s compromise with the critics who have challenged the Bill.

Corporate manslaughter - A landmark decision 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. 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 its 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.

Disclosing confidential patient information to the police. Police officers can exert considerable pressure on NHS staff to disclose confidential patient information. A thorough understanding of professional guidance and best practice is essential in order to avoid criticism or legal action. Claire Bentley and Jane Bennett look at the issues that front line staff should be considering when dealing with police requests for information.

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

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