06/11/2012
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 and Data Sharing |
| Clinical Risk |
Mental Health |
| Commissioning |
Primary Care |
| Employment/HR |
Public Health |
| Finance |
Regulation |
| Foundation Trusts |
General |
| Governance |
Care
Publications/Guidance
Where the heart is: a review of the older people's
home care market in England. This report offers a picture of
the current home care market, some of the challenges it faces and a
model for its future development. It aims to provide a basis for
dialogue between commissioners, consumers and providers about what
home care services might look like in the future. It was written
during the period of consultation on the proposals put forward by
the government in the 2012 care and support white paper.
Joint personal budgets: a new solution to the problem of integrated care? This briefing introduces the concept of joint personal budgets for health and social care and gives the context behind their development. It explains how they might work and lists some of the issues that need to be considered before they could be used at scale to assist in the delivery of integrated care. It also outlines the use of a new tool which gives individual service users control of a single joint budget.
Hospital 2 Home This resource pack contains essential information for all the professional sectors that have a role in hospital discharge for older people in England. It contains information, suggestions for action, case studies and checklists for considering older patients’ housing situations in hospital discharge and transfer of care and for improving integration of housing and support into the process for discharging older people.
End of life care strategy: fourth annual report. This is the fourth annual report on progress in delivering the end of life care strategy, published in 2008. The strategy states that, wherever possible, people should be able to spend their last days in the place of their choosing. This report confirms that almost 30,000 more people have been able to die where they usually live, whether this is at home or in a care home.
Understanding patterns of health and social care at the end of life. This report presents the findings of a study tracking the ways that more than 73,000 people used publicly funded health and social care services during the last months of their lives. It reveals variation between local areas in the care people receive at the end of life and suggests that social care may prevent the need for hospital admission.
Advance Care Planning (ACP): it all ADSE up. This toolkit aims to assist care providers in empowering individuals to discuss and plan the care that they would prefer to receive at the end of their lives, including where they would like to die. The ADSE of the title stands for 'ask, document, share and evaluate', and through the use of these steps care providers are enabled to gather the information and guidance they need to be adequately prepared and confident in supporting the ACP process.
News
Liverpool Care Pathway: Relatives 'must be informed.'
Relatives of terminally-ill patients would have to be consulted
before a decision to withdraw food or water is taken, under new
government proposals. See also Liverpool Care Pathway: Minister will listen to
concerns.
If you wish to discuss any of the items raised in this section please contact Carlton Sadler.
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Children
Publications/Guidance
OCC response to the consultation on proposals for
the joint inspection of multi-agency arrangements for the
protection of children. In response to the consultation on
proposals relating to the new joint inspection of multi-agency
arrangements for the protection of children in England, the
Children's Commissioner recommends: that young victims should
receive early intervention at the earliest possible point; and
children and young people should engage in the inspection process.
The Commissioner also emphasises there is a generous definition of
the category of "at risk" and recommends that barriers are removed
for children and young people who have referred themselves for
help.
Patient Reported Experience Measure (PREM) for urgent and emergency care. These tools have been developed to measure the experience of paediatric patients 0-16 years in all urgent and emergency care settings including GP practices, out-of-hours centres, A&E departments and the ambulance service. The survey was developed with input from paediatric patients, ensuring that their views were captured early in the design process. It aims to help emergency departments, GP surgeries, walk-in or urgent care centres and the ambulance service to identify areas that are important to paediatric patients, as well as areas for improvement.
Bevan Brittan Updates
The responsibilities of doctors in protecting
children and young people GMC Guidance - Protecting Children
and Young People: The Responsibilities of all Doctors came into
effect on 3 September 2012 and provides an advice framework for
doctors. This article by Claire Bentley and Deborah Jeremiah
examines that guidance in overview.
R (on the application of RB) v Devon County Council and Devon Primary Care Trust. On 19 October 2012 HHJ Vosper QC handed down judgment in the case of R (on the application of RB) v (1) Devon County Council and (2) Devon Primary Care Trust. The case highlights the difficulty public bodies face in avoiding legal challenge, but shows that the courts will adopt a pragmatic approach where it is in the interests of good public administration to do so.
If you wish to discuss any of the items raised in this section please contact Deborah Jeremiah or Penelope Radcliffe.
Back to topClinical Risk
Publications/Guidance
Acute care toolkit 4: delivering a 12-hour, 7-day
consultant presence on the acute medical unit. This toolkit
provides practical guidance to senior hospital managers and
clinical staff on how to organise acute medical services to ensure
that the 12-hour consultant presence delivers consistent
high-quality care to acutely ill patients, as recommended by the
the RCP and the Society of Acute Medicine. It covers issues such as
required consultant staff numbers, number of patients to be
reviewed per shift, and optimum organisation of services in order
to deliver this successfully.
Falls and fractures declaration. This declaration is the result of a commitment from the National Osteoporosis Society and Age UK to reducing the rate of hip fractures and falls related injuries in older people over the next five years through adhering to six steps including better partnership working and patient involvement. Both organisations are now calling for this same commitment from health professionals, NHS commissioners and the government.
Patient and Public Involvement (PPI) e-learning tools and resources These resources aim to help organisations achieve successful PPI in clinical audit, and provide tools that organisations can adapt for their own use.
Ten Years of Maternity Claims, an Analysis of NHS Litigation Authority Data. This report analyses maternity claims reported to the NHS Litigation Authority and finds that on the whole, NHS maternity care is safe but more training could reduce the risk of accidental injuries. It is designed to help NHS health professionals responsible for the care of women and their babies to improve safety by learning lessons from the claims that have been made.
The updated never events policy framework. The
never events policy framework has been reviewed and updated in
order to address areas of uncertainty and provide greater clarity
about never events and the recommended response to them following
feedback from stakeholders. It offers a useful reference for
boards, clinicians, other staff and patients.
News
Breast cancer patients recalled after test error. The
Care Quality Commission has launched an urgent inspection of
Sherwood Forest hospitals NHS foundation trust as 79 women in
Nottinghamshire were recalled after mistakes were found in the
testing of breast cancer tissue samples between 2004 and 2010,
which may have led to inappropriate treatment.
Bevan Brittan Updates
Patient safety and clinical governance - The vital
importance of robust record keeping. This article by Claire
Bentley and Georgia Ford looks at some of the key issues that
health professionals need to be familiar with in order to properly
fulfil their duties to patients and to protect themselves and their
employer.
NHS Litigation Authority 10 Years of Maternity Claims Report. Many will now hopefully have seen the NHS Litigation Authority 10 Years of Maternity Claims Report released on 26th October 2012 and had an opportunity to reflect on the considerable press coverage which followed. Described by David Richmond, RCOG Vice President (Clinical Quality) as "a serious wake-up call to all with responsibilities in providing maternity care" the report analyses maternity claims reported to the NHS LA as at 1 April 2010 (from incidents which occurred between 1 April 2000 and 31 March 2010) and is essential reading for those involved with the delivery of care.
Autumn 2012 Cases Review. Our usual review of interesting cases that have caught our attention.
The Jackson reforms: where are we now? In nomine Patris, et Filii, et Spiritūs Sancti. Musketeers. Bee Gees. Wise men. Whether it is the Trinitarian formula, Dumas’ swashbuckling heroes, the brothers Gibb or gift-bearing Magi from the East, many good things undeniably come in threes. With this in mind, what follows should be read as the third - and final - instalment of my series of articles on the progress of the Jackson reforms, tracing developments from the publication of Sir Rupert’s final report in December 2009 to the cusp of implementation.
Damages - the discount rate. The Ministry of Justice has launched a consultation into how the discount rate used to determine the amount of future losses in personal injury claims should be set. The fundamental issue at the heart of the consultation is the extent to which seriously injured Claimants should be regarded as a special class of citizens who require a higher level of financial protection than the rest of society.
Meet the NHS LA Chief Executive Catherine Dixon. Joanna Lloyd, puts a number of questions to the new Chief Executive of the NHS Litigation Authority, Catherine Dixon. Catherine was previously General Counsel and Company Secretary at the NSPCC, working as part of the Executive Team.
Bevan Brittan Events
Seminar: Emergency Response in the Healthcare Setting. 06
December 2012 : 10.00am - 12.30pm (Registration 9.30am). Location:
Bevan Brittan LLP, Fleet Place House, 2 Fleet
Place, Holborn Viaduct, London, EC4M 7RF. Since the introduction of the Corporate
Manslaughter & Corporate Homicide Act 2007 (“CMA”), there has been
a sharp increase in the number of police investigations into deaths
following serious incidents in the healthcare setting. To
date, there have been two successful prosecutions under the CMA and
around 50 investigations underway throughout the UK. The
purpose of this Seminar will be to provide an update on the CMA by
reviewing the 2 successful prosecutions and reviewing the likely
circumstances that may lead to an investigation.
If you wish to discuss any of the items raised in this section please contact Joanna Lloyd or Julie Chappell.
Commissioning
Publications/Guidance
Co-production and participation: older people with
high support needs. This summary of research literature
identifies benefits and barriers to co-production and participation
among older people with high support needs, and highlights examples
of good practice. It will be relevant to commissioners of social
and health care services, and service users developing the
co-production and participation agenda in care provision and
service development.
Commissioning person centred end of life care: a toolkit for health and social care professionals. This guide identifies the main elements involved in commissioning end of life care services, explains the commissioning cycle in practical terms and offers a four-stage approach across all sectors. It provides a wide range of links to tools and sources of support for both commissioners and providers of services. It also showcases good practice and seeks to indicate what a well-commissioned end of life care service looks like.
Sessional GPs in commissioning. This report surveyed sessional GPs and those involved in emerging CCGs in order to find how engaged sessional GPs are with commissioning and to find examples of best practice, models of inclusion, engagement and leadership including the necessary conditions for their success, along with any barriers preventing these.
Bevan Brittan Updates
R (on the application of RB) v Devon County Council and Devon
Primary Care Trust. On 19 October 2012 HHJ Vosper QC
handed down judgment in the case of R (on the application of RB) v
(1) Devon County Council and (2) Devon Primary Care Trust.
The case highlights the difficulty public bodies face in avoiding
legal challenge, but shows that the courts will adopt a pragmatic
approach where it is in the interests of good public administration
to do so.
Bevan Brittan Events
Health and wellbeing boards and the new integration agenda: London
Seminar. 08 November 2012 : 10.00am - 12.30pm (Registration at
9.30am). Location: Bevan Brittan LLP, Fleet Place House, 2 Fleet
Place, Holborn Viaduct, London, EC4M 7RF. This seminar will
help you to understand the new and complex relationship between
Health and local government, and in particular the key role of
Health and wellbeing boards in driving the co-operation between and
where appropriate the integration of services and how this can fit
withint the overall objectives for an area. This is of
particular interest as the government is apparently considering
using its forthcoming Care and Support Bill to require clinical
commissioning groups to pool part of their budgets with local
authorities.
register your interest in this event.
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
Evidence submissions to the NHS Pay Review
Body. These evidence submissions to the NHS Pay Review Body
make recommendations around pay for Agenda for Change staff from
various professional organisations.
A fair route to revalidation This guidance aims to provide an easy-to-follow checklist that encourages reflection on where equality and diversity issues may arise in preparing for and implementing the appraisal process that will support a doctor’s revalidation. It offers examples and signposts to more detailed information. It is aimed primarily at Responsible Officers who will be making recommendations about revalidation.
NHS pay review body’s remit for 2013/14 This letter outlines remit of the the NHS Pay Review for 2013/14 in respect of NHS staff on Agenda for Change pay, terms and conditions. The independent Pay Review Bodies (PRBs) make recommendations to the UK Governments on changes to pay and other subsidies eg cost of living supplements, for public sector staff within their remit groups. For those years that PRBs are invited to make recommendations, they receive a remit from the Governments.
Mitigating equal pay risks following the end of the Computer Aided Job Evaluation system (CAJE) This guidance describes the equal pay risks for organisations, and how to mitigate these risks, once CAJE provision comes to an end on the 31st December 2012. It sets out what employers should seek from any replacement computer aided job evaluation tool, sign posts specific advice about consistency checking of job matching and evaluation outcomes and advises on how to manage the data currently within the CAJE system once it has been returned to employers. It is aimed mainly at English employers, but its principles apply to all NHS employers in the UK.
Regional pay in the NHS - Commons Library Standard Note. A House of Commons Library Standard Note provides background to the House of Commons Opposition-day debate on regional pay in the NHS on November 7, 2012.
News
Doctors want changes to EU rules restricting
working hours. The Presidents of the Royal Colleges of Surgeons
and Physicians have warned that the restrictions on doctors' hours
need to be changed and patient care is being put at risk by the
European Working Time Directive. The Royal Colleges say patients in
hospitals see a 'conveyor belt' of doctors on different shifts and
trainee doctors are not receiving the same hands-on experience as
before.
Bevan Brittan Updates
Establishing the meaning of establishment. The Employment
Appeal Tribunal has revisited the definition of ‘establishment’ in
the context of collective consultation over redundancies – can a
school be a separate ‘establishment’ or is the correct
establishment an education department? This particular case
concerned a local authority, but the principles set out by the EAT
around the approach to be taken in defining establishments, are of
general relevance. Victoria McMeel reports.
News round up. This ‘Halloween edition’ of our employment news bulletin is all treat and no tricks, as Mike Smith explains October’s key developments, including: new social media guidelines; some practical points on harassment from the Employment Tribunal; the new ‘shares for rights’ proposals and an update on draft legislation on equal pay audits and equalities.
Trigger points - an update on starting collective consultation.When is the obligation to consult on collective redundancies triggered? When an organisation is considering a proposal that will inevitably lead to redundancies (such as complete closure of a workplace); or only when that decision has been made and consequential redundancies are proposed? It had been a settled position since 2007, that consultation should start when an employer has made a firm (albeit provisional) proposal that will result in redundancies; but this had been thrown into some doubt recently and, this month, the ECJ declined to provide some much needed clarity. Julian Hoskins traces the case law developments and summarises where we are now.
If you require further information about any of the items raised in this section please contact Julian Hoskins or James Gutteridge.
FinancePublications/Guidance
Department of Health annual report and accounts
2011-12. This report provides parliament and the public with an
account of how the Department of Health has spent the resources
allocated to it. It provides commentary on departmental
performance, structural and transition changes and progress against
the structural reform plan.
All together now: competitive integration in the NHS. This report argues that NHS funding arrangements encourage acute hospitals to admit patients to hospital to service high fixed costs for staff and property rather than trying to treat patients at a community level or in the home. It also finds that by international standards patients in England with chronic diseases are more likely to be admitted to hospital and stay much longer once admitted.
Hospital quality competition under fixed prices. This interim report investigates the relationship between quality of health care and competition amongst providers in three sectors: hospital care, primary care (general practice) and social care (nursing and residential homes).
Driving improvements in A & E services. This benchmarking study found that A&E departments are seeing increasing numbers of patients but, despite improving their efficiency and innovating, seven out of ten trusts were shown to lose money on their A&E patients. It emphasises that fundamental problems remain on the funding of A&E and emergency services.
Securing the future financial sustainability of the
NHS This report examines the financial sustainability of the
NHS, and states that ensuring a viable financial future for
healthcare providers is vital if the public are to have confidence
in the delivery of their local services. It argues that there is a
lack of clarity around critical details of how the system
introduced by the NHS reforms will work so that services remain
available to patients in their locality.
Finance transition planning. This draft
checklist covers the key year end finance transition areas that
SHAs and PCTs will need to plan for in 2012/13. PCTs and SHAs are
encouraged to use this document to ensure they have considered and
addressed the main elements of finance transition in their
planning.
Payment by Results: how can payment systems help to deliver better care? This report reviews the role and objectives of payment systems in the English NHS, focusing on Payment by Results (PbR), which accounts for around 30 per cent of the total English NHS budget. It also considers the experiences of other countries using similar payment systems. It explores whether such systems are still fit for purpose, given changing policies and priorities, such as the need for disease prevention, the prevalence of long-term conditions, the changing economic environment. It argues that more flexibility should be encouraged in payment systems to accommodate change and offer the right incentives for cost-effective, high-quality care, and considers the policy implications of this.
If you require further information about any of the items raised in this section please contact David Owens.
Back to topFoundation TrustsGuidance /Publications
NHS foundation trusts: review of three months to
30th June 2012 This first quarterly report for 2012/13
summarises the key trends drawn from individual reports of the 144
trusts authorised up to 30th June 2012. It emphasises that focus to
drive improvement for patients through effective regulation. It
also considers in more detail, the reconfiguration of services.
Legislation
The Health and Social Care Act 2012 (Commencement
No.3, Transitional, Savings and Transitory Provisions and
Amendment) Order 2012. This Order brings into force provisions
of the Health and Social Care Act 2012 (c. 7) (“the Act”). It is
the third such Order to be made under the Act. It also amends the
Health and Social Care Act 2012 (Commencement No.2 and
Transitional, Savings and Transitory Provisions) Order 2012. See
explanatory note.
If you require further information about any of the items raised in this section please contact Vincent Buscemi.
Back to topGovernanceConsultations
Consultation on the regulation and governance of
NHS charities. This consultation seeks feedback from NHS
bodies, their charities, patient groups and other interested
organisations on final proposals to revise the governance of NHS
charities. These proposals will: remove regulation by ministers;
enable NHS charities to establish and operate more flexibly and
independently, in the interests of donors and patients; and
preserve the close relationship with the providers of NHS services
that the charities support. Comments are invited until the 31st
January 2013.
If you require further information about any of the items raised in this section please contact Vincent Buscemi.
Back to topHealth and SafetyGuidance/Publications
Not the Francis Report. This report calls for
greater urgency in improving patient safety and care quality. It
warns that delays to the Francis Report could also create delays on
improvements in care quality in the NHS and the report makes a
number of recommendations for improving patient safety and the
quality of patient care. These recommendations include greater
patient and public involvement; the reorganisation of hospital
services; and a drive towards integrated primary care.
Safe staffing for older people’s wards. This
toolkit provides practical help when assessing nursing staff levels
on older people’s wards, or wards where the large majority of
patients are older people, and when checking whether they meet
recommendations for safe care. It can be used to support a review
of staffing on hospital wards where older people are cared for; to
help address any associated leadership and workforce issues; and to
guide the development of an action plan to identify how, and to
whom, actions should be addressed.
The updated never events policy framework. The never events policy framework has been reviewed and updated in order to address areas of uncertainty and provide greater clarity about never events and the recommended response to them following feedback from stakeholders. It offers a useful reference for boards, clinicians, other staff and patients.
News
For sale: an EU licence for faulty medical
implants. The Secretary of State for Health has asked the
Medicines and Healthcare Products Regulatory Agency to examine what
it can do to ensure the high quality of medical devices. The move
follows an investigation by the British Medical Journal and Daily
Telegraph that exposed loopholes in the EU system for approving
devices.
Walsall health trust fined over patient death. Walsall
Hospital NHS Trust has been ordered to pay almost £107,000 in fines
and costs after a pensioner died following a fall from a first
floor window at Walsall Manor Hospital.
If you require further information about any of the items
raised in this section please contact Joanna
Lloyd.
Publications/Guidance
Determining whether information is held. This
is part of a series of guidance that goes into more detail than the
Guides, to help public authorities to fully understand their
obligations and promote good practice.
If you wish to discuss any of the items raised in this section please contact Jane Bennett.
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Mental Health
Bevan Brittan Mental Health Extranet.
This is a free resource for Bevan Brittan NHS clients. Bevan
Brittan has a wealth of mental health knowledge it would like to
share with NHS clients. We have therefore developed an online
searchable extranet designed to bring various sources of mental
health information and guidance into one place.
The extranet also contains a forum for use by members to share
knowledge and information. Forum issues currently being discussed
are:-
Approving doctors working under the Mental Health
Act The Mental Health Act and Health and Social Care Act
2012
ECT - fluctuating capacity
Tribunal - Discharged from liability to be detained
37/41 patient then detained on s3 who has s117
If you would like information about how to access the Bevan Brittan Mental Health Extranet please email Claire Bentley by clicking here.
Training - If you would like to know about our lunch time training sessions just let Claire Bentley know. You can attend in our London, Bristol or Birmingham office.
Publications/Guidance
Technical change to the process for approving
doctors working under the Mental Health Act. Letter outlining a
technical issue that has been identified in the way some strategic
health authorities have been administering the process for
approving doctors to work under the Mental Health Act.
A guide to interpreting and engaging with local change. This guidance aims to assist professionals in their understanding of NHS commissioning, to encourage staff to feel confident when engaging with other practitioners, to promote services and raise the profile of counselling and psychotherapy within the NHS.
Analysis of the consultation on allocation options for the funding for independent mental health advocate services and the treatment of armed forces’ compensation in charging for social care. This consultation response summarises views received on options for distributing funding to local authorities for Independent Mental Health Advocate (IMHA) services and the treatment of armed forces’ compensation in charging for social care. The IMHA service will be funded by Department of Health grant from April 2013 onwards. Further details about the allocation of the grant will be made available in late 2012, alongside the provisional 2013/14 local government finance settlement.
My life until the end: dying well with dementia
This report reveals that many people with dementia are not dying in
the place they want to, with their families unaware of their end of
life wishes because of a double stigma around dementia and death.
It highlights the importance of planning end of life care in
advance to help make the final days of more people with dementia as
good as possible and in the place they want to be.
Out
of sight This report is part of a campaign to end poor care and
abuse at large, institutional-style services for people with a
learning disability. It expresses concern that government proposals
in the interim report of the Winterbourne review don't go far
enough, and calls for the phased closure of such services, and
their replacement by appropriate local services.
Application of the Mental Health Act 1983 This
letter announces that the Department of Health is taking action to
correct an irregularity in the application of the Mental Health Act
1983. A technical issue has been identified in the way some
strategic health authorities have been administering the process
for approving doctors to work under the Act. The advice is that
this irregularity should be resolved through emergency
retrospective legislation, which will be in force this week. This
will retrospectively validate the approval decisions that were made
and will apply in principle to the approval of all doctors under
the Mental Health Act from its introduction in 1983 up until Friday
26th October. Patients assessed from now on will continue to be
assessed under the current provisions.
Inpatients formally detained in hospitals under the Mental
Health Act 1983, and patients subject to supervised community
treatment, Annual figures, England, 2011/12.The latest data for
2011/12 suggest that the number of people subject to detention
under the Mental Health Act continues to rise. There is increasing
use of Community Treatment Orders (CTOs) with nearly half ending
with the reinstatement of the underlying detention. Section.
Social and emotional wellbeing for children and
young people This guidance aims to help to strengthen home
visiting and early education services, and recommends that health
professionals are alert to any factors that may pose a risk to a
child's social and emotional wellbeing. It recommends that each
health and wellbeing board should ensure that the social and
emotional wellbeing of vulnerable children features in its health
and wellbeing strategy, as one of the most effective ways of
addressing health inequalities.
Recovery, public mental health and wellbeing
This paper argues that local councils and the new health and
wellbeing boards can support the commissioning of recovery-oriented
services, as well as promoting good mental health and wellbeing in
communities. It outlines the ways in which health and wellbeing
boards can influence commissioning to promote and protect mental
wellbeing and support recovery.
A report by the Health Service Ombudsman and the
Local Government Ombudsman about the provision of section 117
aftercare This report outlines findings from a joint
investigation into a complaint made about the standard of mental
health care provided in a specific case, and particularly about the
necessity for the patient in question to fund their own placement
in a residential care home.
Thematic report by HM Inspectorate of Prisons: The
use of the person escort record with detainees at risk of
self-harm: A thematic review. An HM Inspectorate of Prisons
report sets out recommendations to improve the processes by which
information about a person's risk of self-harm is transferred and
used as they move between police custody, court and prison and on
other external journeys. Recommendations include: improving the
training of staff involved in recording self-harm information;
improving quality assurance by police forces; and changes in the
design of the person escort record.
Dementia guide: commitment to the care of people with
dementia in hospital settings. This guide aims to help nursing
staff care for people with dementia in hospital. It supports
further implementation of the RCN’s five principles for improving
the quality of care for people with dementia. It also aims to
enable the best possible support for carers.
Mental health discharge summary collaboration.
This project was conducted with the Royal College of Psychiatrists
and aimed to create and help implement a standard discharge summary
from mental health in-patient care, to be sent to general
practitioners. The approach involved the development of a
collaboration website in order to generate rapid consensus and
ensure transparency of the work undertaken. The final mental health
discharge summary headings have been agreed and can be viewed on
the collaboration site with a guest login.
Mental health and the market. This briefing by
the NHS confederation summarises the main findings of a Department
of Health commissioned report on the current landscape for mental
health service provision in England. It aims to provide CCGs with a
clearer understanding of the way in which the market currently
operates in the mental health sector, and will assist in the
development of effective commissioning arrangements.
No health without mental health: guides for local
services. This series of briefings aim to help develop better
local mental health services. Following the publication of the
implementation framework for the government’s mental health
strategy, these briefings set out the steps that local authorities,
CCGs, and those involved with Healthwatch and health and wellbeing
boards can take to improve mental health care, treatment and
support.
CCG briefing
Local Healthwatch briefing
Health and wellbeing board briefing
Directors of Public Health briefing
Local authorities briefing
Overview and scrutiny committees briefing
Centre for Mental Health - press release
Improving the health and wellbeing of people with
learning disabilities: an evidence-based commissioning guide for
clinical commissioning groups The guide is intended to help
CCGs commission high quality, cost effective general and specialist
health services for people with learning disabilities; jointly
commission services for people who challenge services and those
with complex needs; and work with health and wellbeing boards,
local authorities and others to address the social factors which
affect the health of people with learning disabilities.
Incorporating mental health and employment in your
joint strategic needs assessment and health and wellbeing
strategy. This guidance highlights the importance of health and
employment to CCGs, HWBs, directors of adult social service and
other partners responsible for promoting public health and
delivering personal responses to people at risk of long-term
illness and social exclusion. It aims to help local commissioners
and planners incorporate mental and employment considerations into
their joint needs assessment and health and wellbeing strategy.
Protecting adults at risk in London: Good practice
resource. A new easy-to-use online resource will help people
who work in adult social care to carry out their responsibilities
to safeguard adults at risk. It gives practical pointers to help
staff to assess the risk of abuse, to recognise it when it does
occur and to respond to it appropriately. It also gives quick and
easy access to the pan-London "safeguarding protocol". This helps
frontline safeguarding staff across the capital to carry out
cross-borough and cross-agency work to prevent and investigate
abuse. Although the resource focuses on London, it will be of
interest to a wider audience.
Talking self-harm. This report argues that
there is a need for more awareness about self-harm amongst young
people, parents and professionals. It makes recommendations for
more training for healthcare professionals and places emphasis on
the need for guidance for GPs on how assessment tools such as NICE
guidelines can support the consultation and referral process.
Next steps in developing a payment mechanism in
mental health. The HFMA mental health faculty have produced
this discussion paper on the development of mental health payment
by results.
Legislation
Amendments to the high security psychiatric
services directions 2012. These directions apply to the 3
trusts which provide high secure mental health services at
Ashworth, Broadmoor and Rampton Hospitals. They should be read
alongside the High Security Psychiatric Services (Arrangements for
Safety and Security at Ashworth, Broadmoor and Rampton Hospitals)
Directions 2011 and associated guidance.
Mental Health (Approval Functions) Act 2012 published on 1 November 2012. This Act authorises retrospectively the exercise of functions relating to the approval of registered medical practitioners and clinicians under the Mental Health Act 1983. It comes into force on 31 October 2012. It retrospectively gives powers to those people who exercised 'approval functions' under the Mental Health Act 1983, s 12 in order to approve doctors as eligible to assess whether certain patients need to be detained or hospitalised. The Mental Health (Approval Functions) Bill was moved by Earl Howe, the Parliamentary under-secretary of state, Department of Health. It was necessary in order to correct a technical irregularity which had arisen involving the approval process of doctors who make assessments of patients to see if they need to be detained or hospitalised. Doctors who assess patients, and make recommendations under the Mental Health Act 1983, are required under section 12 to be ‘approved’ to do so. The Act requires the approval to be by the Secretary of State and the Secretary of State delegated that approval function to Strategic Health Authorities in 2002. However, four out of the ten SHAs (including North East, Yorkshire and Humber, West Midlands and East Midlands) asked mental health trusts to carry out the validation and approval process for them, but did not ask for it to be referred back to them for final confirmation.
News
Ministry of Justice consultation Transforming the
Services of the Office of the Public Guardian: Response of the Law
Society of England and Wales. Responding to a Ministry of
Justice consultation on the digital transformation of the Office of
the Public Guardian (OPG) service, the Law Society states that any
new lasting powers of attorney (LPA) form developed by the OPG
should be simple and straightforward as the LPA form is designed to
be completed by members of the public and if the current form is
made more complicated or becomes confusing, this will increase the
chances of individuals filling out the form incorrectly.
Guide to councils' new deprivation of liberty
duties in hospitals. From next April councils will have to
assess and authorise Deprivation of Liberty Safeguards applications
in hospitals. Rachel Griffiths, co-author of forthcoming guidance
on the change, explains its implications in Community Care.
Mental Health sectioning error. Health Secretary
Jeremy Hunt says urgent retrospective legislation is needed to
correct a "technical error" affecting up to 5,000 patients
sectioned under the Mental Health Act since 2002.
If you wish to discuss any of the items raised in the above section please contact Simon Lindsay.
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Primary Care
Publications/Guidance
Sessional GPs in commissioning. This report
surveyed sessional GPs and those involved in emerging CCGs in order
to find how engaged sessional GPs are with commissioning and to
find examples of best practice, models of inclusion, engagement and
leadership including the necessary conditions for their success,
along with any barriers preventing these.
Consultations
Consultation on national performers list for GPs,
dentists and ophthalmologists. A consultation proposing that in
future, there is one national list of general practice doctors,
dentists and ophthalmologists approved to provide NHS primary care
services has been launched. Closing date is 14.12.12.
Bevan Brittan Updates
CQC registration for GPs. Much work has been undertaken by CQC,
in conjunction with GPs across the country, to simplify and test
the application process. The application forms are submitted
online and CQC anticipates that they should take providers less
than 2 hours to complete. However, although completion of the
form itself may be straight forward, the whole process of ensuring
providers are properly prepared to make the application, and geared
to deal with ongoing monitoring of compliance following the grant
of registration, raises important questions for GPs to
consider:
If you wish to discuss any of the items raised in the above section please contact David Owens.
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Public Health
Publications/Guidance
The real cost of alcohol: a map of alcohol harm across
England. This map reveals the cost of alcohol abuse to local
health services. It provides regional data on hospital admissions,
deaths and costs relating to alcohol.
The Slope Index of Inequality (SII) in life expectancy:
interpreting it and comparisons across London. This briefing is
intended to aid London’s public health professionals by explaining
how to interpret the SII; comparing 2006-2010 SII scores across
London; illustrating SII trends across local areas; and
demonstrating how to use an SII to drive local area
improvement.
Protecting People, Promoting Health – A public health
approach to violence prevention in England. A public health
approach to preventing violence is set out in a new report which
draws on the latest evidence to show that many of the key risk
factors that make individuals, families and communities vulnerable
to violence are changeable. The report also contains new figures on
the cost of violence, estimating national costs to the NHS and a
wider cost to society.
If you wish to discuss any of the items raised in the above section
please contact Olwen Dutton.
Regulation
Legislation
Monitor takes on new powers to protect patient
services at failing hospitals. Monitor has taken on a series of
new powers under the Health and Social Care Act 2012 to enable the
regulator to protect patient services at failing hospitals. The new
Trust Special Administration regime enables Monitor to appoint
administrators to work with local commissioners to ensure that
services are protected if a trust becomes insolvent. This regime is
designed to protect patient services ahead of creditors if trusts
break down financially. Under the Trust Special Administration
system, options for the continued provision of services include
restructuring the existing service provider, using other providers
to continue services at existing sites, relocating services to
other local providers, or bringing in new providers such as an
out-of-area provider wanting to expand.
News
Wrinkle treatments should be regulated, says
British Association of Aesthetic Plastic Surgeons. Injectable
anti-wrinkle treatments should be classed as medicines so they can
be properly regulated, the British Association of Aesthetic Plastic
Surgeons (Baaps) said.
Bevan Brittan Updates
CQC registration for GPs. Much work has been undertaken by CQC,
in conjunction with GPs across the country, to simplify and test
the application process. The application forms are submitted
online and CQC anticipates that they should take providers less
than 2 hours to complete. However, although completion of the
form itself may be straight forward, the whole process of ensuring
providers are properly prepared to make the application, and geared
to deal with ongoing monitoring of compliance following the grant
of registration, raises important questions for GPs to
consider.
If you wish to discuss any of the items raised in this section please contact Carlton Sadler.
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General
Publications/Guidance
Health service reconfiguration debate briefing
This briefing argues the urgent need for a full and open debate
between politicians, the public and the health sector about the
future of the NHS over the next ten to fifteen years. It recognises
the need to better engage with local populations to explain how
proposals for reconfiguration and service change will improve
patient care and listen to what communities say in response. It
asks that local politicians, including MPs and councillors, support
open public discussions by engaging with the clinical evidence
about patient outcomes, convenience and care quality.
Quality with Compassion: the future of nursing
education. The Willis Commission has now published its full
report into the future of nursing education. See the key findings
from the report below:-
Patient centred care should be at the
heart of all pre-registration nursing education and continuing
professional development.
There were no shortcomings found in
nursing education that could be directly responsible for poor
standards of care or a decline in care standards.
Nurses and their organisations must
stand up to be counted on the challenge of poor care and loss of
public confidence in order to restore professional pride.
Nursing education needs to imbed
patient safety and dignity as a top priority.
Better evaluation of and research into
nursing education programmes is necessary to ensure a programme
that is fit for purpose.
The future nursing workforce requires
nurses to work in a variety of settings.
Recruitment campaigns need to widen
their diversity in order to encourage the widest, best possible
range of applicants.
Health care service providers must
fully support nursing education.
Universities need to recognise nursing
as a practice and research discipline
Attention needs to be paid to
developing a strategic understanding of the nursing workforce as a
whole and as a UK-wide resource.
NHS Property Services – estates operating information. As indicated in the baseline spend exercise of June 2012, further operating information is now needed in order for NHS Property Services (NHS PS) to build a finance ledger and to maintain continuity of estates services from April 2013. This requires an exchange of operational estates information between primary care trust (PCT) and strategic health authority (SHA) finance teams and NHS PS.
Survey on public perceptions of the NHS. This annual survey provides a useful check on public sentiment and experience relating to the NHS.
Driving improvements in A & E services. This
benchmarking study found that A&E departments are seeing
increasing numbers of patients but, despite improving their
efficiency and innovating, seven out of ten trusts were shown to
lose money on their A&E patients. It emphasises that
fundamental problems remain on the funding of A&E and emergency
services.
A guide to the OFT's investigation procedures in
competition cases. The OFT has issued updated guidance on its
investigation procedures in competition cases that sets out new
decision-making processes and procedural enhancements to boost the
speed and robustness of Competition Act 1998 investigations and
increase engagement with parties involved.
Letter to NHS bodies on the report of the
Hillsborough Independent panel. In light of the Hillsborough
Independent Panel's reports, NHS Chief Executive, Sir David
Nicholson, has written to NHS organisations to ask them to review
their arrangements for responding to major incidents and take
appropriate action to ensure their current practices and processes
are robust. The NHS Commissioning Board is working closely with
local agencies and its partners to establish new arrangements for
emergency preparedness, resilience and response (EPRR) from April
2013.
Speaking up charter. This charter outlines a
commitment by those signed up to working together to promote
cultural change in the NHS. 28 organisations have signed the
charter, recognising their separate but linked responsibilities for
key aspects of the provision and regulation of care, and for
supporting members to provide high quality, safe care. It aims to
send the message that leadership must come from national
organisations to promote a cultural shift in the NHS where staff
can report concerns with confidence.
Engage toolkit for black and minority ethnic (BME) family carers. This toolkit is a resource to address barriers BME family carers face when accessing services. It is available to practitioners and a wide range of organisations who work in adult and children services. It will provide practical support and opportunities for joint working between community groups, multi-agencies and the families themselves to ensure family carers are given the best practical support available. As a live toolkit, the website will share resources of events, community projects and appropriate policy and practice when working with BME family carers.
Handover and close down guidance for transition to
the new health and care system. This guidance is published
primarily for strategic health authorities (SHA) and primary care
trusts (PCT) transition directors, lead and governance leads. This
guidance fits with the transition communications planning for a
secure transition to the new health and care system.
Multi-agency public protection arrangements annual
report 2011/12. This multi-agency public protection
arrangements annual report sets out how the arrangements to assess
and manage the risk posed by sexual and violent offenders in their
area. These arrangements are known as MAPPA (Multi-Agency Public
Protection Arrangements). These reports cover the period 1 April
2011 to 31 March 2012.
Access all Ages: Assessing the impact of age on access to surgical treatment. A report from the RCS and Age Concern warns that decisions on whether older people are put forward for surgery must not be based on out-dated assumptions of age and fitness.
Evaluation of NHS 111 pilot sites: final report. This is the final report of the evaluation of NHS 111, a new telephone based service designed to help people access appropriate healthcare for urgent medical problems. It assessed the first year of operation of NHS 111 in four pilot sites, and examined the extent to which the service has achieved its objectives, as well as its usefulness and cost-effectiveness.
House of Commons Science and Technology Committee Regulation of medical implants in the EU and UK: Fifth Report of Session 2012-13: Report, together with formal minutes, oral and written evidence: Additional written evidence is contained in Volume II. A Science and Technology Committee report recommends that the Government presses for greater transparency and a more evidence-based approach to the regulation of medical devices, particularly implants.
Consultations
Consultation on licensing: small providers.
This consultation seeks views from NHS providers on what type of
services they provide, how many staff they employ, and what annual
turnover they get from providing NHS services. This is in order to
further understand the impact of proposals exempting small
providers from the need to have a licence from Monitor. Views on
this are welcomed until 22 October 2012.
Intellectual Property Office: Proposals to exempt clinical and field trials using innovative drugs from patent infringement - A consultation This to get stakeholders’ views on proposals to amend section 60(5) of the Patents Act 1977 to provide an exception to patent infringement for activities involved in preparing or running clinical or field trials which use innovative, or non-generic, drugs.
A consultation on strengthening the NHS
Constitution. Proposals to strengthen the NHS Constitution are
set out for public consultation , with the NHS, patients and public
are all being asked to respond. The main changes proposed
cover:
a new responsibility for staff to
treat patients not only with the highest standards of care, but
also with compassion, dignity and respect
a new pledge making it explicit that
patients can expect to sleep in single-sex wards
a new pledge to patients that NHS
staff must be open and honest with them if things go wrong or
mistakes happen – this ‘duty of candour’ will become a condition in
the NHS Standard Contract from April 2013.
The changes also make it clearer that:
patients, their families and carers
should be fully involved in all discussions and decisions about
their care and treatment, including their end of life care
patients who are abusive or violent to
NHS staff could be refused treatment
the NHS is equally concerned about
physical and mental health.
Protecting patients’ interests – ensuring continuity of NHS services: a consultation on proposals for a health special administration procedure for companies. This health special administration consultation sets out how safeguards to protect the services that patients need will be extended to NHS services provided by social enterprises and other companies. For the first time, the services provided by these organisations will be secured if they become insolvent. This will ensure that, regardless of the type of provider, patients will receive an uninterrupted service they can rely on. It gives an overview of the proposed health special administration procedure and seeks views on the overall design of the regime. Views are welcomed until the 4th January 2013.
Legislation
The Health and Social Care Act 2012 (Commencement
No.3, Transitional, Savings and Transitory Provisions and
Amendment) Order 2012. This Order brings into force provisions
of the Health and Social Care Act 2012 (c. 7) (“the Act”). It is
the third such Order to be made under the Act. It also amends the
Health and Social Care Act 2012 (Commencement No.2 and
Transitional, Savings and Transitory Provisions) Order 2012. See
explanatory note
News
One step further in cross-border organ
traceability. The European Commission has adopted legislation
to increase cross-border exchanges of information regarding organs
and their donors. The intention is to increase the traceability of
organs, in particular for cases where patients suffer adverse
reactions.
NHS London guidelines state doctors must register any foreign-born patient, giving them access to primary NHS care, and that practices cannot insist on seeing passports. The stated aim of the guidance is to "promote human rights and public health". However, the guidance has attracted criticism from doctors and MPs
New principles set out for hospital food. New standards setting out what patients should expect from NHS hospital food have been announced by Health Secretary Jeremy Hunt.
Winterbourne View care staff jailed for abuse.
Over-65s heart death inequality. The gap in heart disease deaths for over-65s in the richest and poorest areas has widened since the 1980s - despite general improvements over that time.
On 31 October 2012 the Advertising Standards Authority (ASA) upheld a complaint against cosmetic surgery clinic Lasercare Clinics (Harrogate) Ltd, trading as Sk:n, regarding claims for a treatment to remove stretch marks.
If you wish to discuss any of the items raised in this section please contact Claire Bentley.
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