10/01/2013
Legal intelligence for professionals in health and social care
This Update contains brief details of recent Government publications, legislation, cases and other developments relevant to those involved in health and social care work, which have been published in the last month.
If you have been forwarded this update by a colleague and would like to receive it directly, please email Claire Bentley.
Care
Publications/Guidance
Seven day Consultant Present care. This report
from the Academy of Medical Royal Colleges, which brings together
20 colleges and faculties, outlines its commitment to delivering
high quality care to patients seven days a week. The publication
recommends three key standards to ensure all patients receive high
quality care led by a consultant regardless of the day of the
week:
hospital inpatients should be reviewed
by an on-site consultant at least once every 24 hours, seven days a
week, unless it has been determined that this is not necessary for
the patient;
consultant-supervised interventions
and investigations along with reports should be provided daily if
the results will change the outcome or status of the patient’s
overall care before the next ‘normal’ working day. This should
include interventions which will enable immediate discharge or a
shortened length of stay; and
setting should be available daily to
ensure that the next steps in the patient’s treatment, as
determined by the daily consultant review, can be taken. It also
acknowledges that it is outside its scope to look in detail at
community services.
It raises a series of areas for improvement and highlights that it
is unacceptable to not provide consultant-led care at weekends if
evidence suggests that this is best for patients.
Delivering Dilnot: paying for elderly care. This report includes comments from a wide range of contributors, including: Paul Burstow, former Care Services Minister under the Coalition; Lord Sutherland, former chair of the Royal Commission on Long Term Care under Labour; as well as carers and elderly patients. It emphasises that tough political decisions must be made to deliver reform, and proposes how this can be funded a way that is fair and sustainable. It also looks at the private sector contribution to delivering the necessary insurance products.
Cases
R (Chatting) v (1) Viridian Housing (2) Wandsworth
LBC [2012] EWHC 3595 (Admin) (Admin Ct). The court held that on
the proper construction of a compromise agreement, a charity's
transfer to another organisation of the provision of accommodation
and care to an elderly woman, paid for by the local authority under
s.26 of the National Assistance Act 1948, was lawful and compliant
with Art.8 ECHR, so long as those services were provided until
nursing care was needed. There was no requirement that the legal
identity of the organisation providing or managing that care and
accommodation had to be maintained.
If you wish to discuss any of the items raised in this section please contact Carlton Sadler.
Back to top
Children
Publications/guidance
Health visitors leading the way in transforming
services for children and families. These case studies
highlight innovations developed as part of the Health Visiting
Programme. They focus on improvements in service quality and
innovation, specifically along the strands of the ‘health visiting
service vision and family offer’. They are intended as a resource
for sharing and learning amongst NHS public health professionals
and early years staff.
News
New child abuse alert system for hospitals
announced . Announces that hospital emergency departments and
urgent care centres will have a new Child Protection Information
System to help doctors and nurses spot children suffering from
abuse and neglect. Doctors and nurses will be able to see if the
children they treat are subject to a child protection plan or being
looked after by the local authority, or have frequently attended
emergency departments or urgent care centres over a period of time.
Work on the system will begin in early 2013 and it will start to be
introduced to NHS hospitals in 2015.
If you wish to discuss any of the items raised in this section please contact Deborah Jeremiah or Penelope Radcliffe.
Clinical Risk/Health and Safety
Publications/Guidance
Using safety cases in industry and healthcare.
This report presents the results of a study that reviewed the use
of safety cases in six safety-critical industries, as well as the
emerging use of safety cases in healthcare. The aims of the study
were to describe safety case use in other industries, to make
pragmatic recommendations for the adoption of safety cases in
healthcare and to outline possible healthcare application
scenarios.
Zero tolerance - making ambulance delays a thing of the past. This report by the NHS Confederation is intended to support healthcare leaders in their efforts to make handover delays a never event in their local health economies.
The code: standards of conduct, performance and ethics for nurses and midwives. This code sets out a foundation for good nursing and midwifery practice, and will act as a key tool in safeguarding the health and well-being of the public.
Hepatitis B and C: ways to promote and offer testing to people at increased risk of infection. This advice tool considers implementation issues that are specific to the published guidance. It provides practical suggestions for action to help those responsible for planning and implementing staff training. It is aimed at commissioners, service leads and others providing training for professionals working with people at increased risk of infection. The latest pathway on hepatitis B and C aims to ensure more people who are at increased risk of infection are tested, and says GPs and practice nurses should offer testing for hepatitis B and C to adults and children at increased risk of infection.
Review of the regulations of cosmetic
interventions: summary of the responses to the call for
evidence. This report summarises responses to a call for
evidence issued as part of NHS Medical Director Sir Bruce Keogh’s
review of the regulation of cosmetic interventions. Many
respondents felt that: training requirements were
disproportionately weak; there is a lack of data being collected on
implants, procedures, adverse incidents and outcomes; and there are
some procedures where legislation is insufficient to protect the
public. Suggestions welcomed by respondents included: the banning
of free consultations for cosmetic surgery; tighter restrictions on
advertising, including the banning of offers on procedures; and
better patient information on the potential risks and side-effects
of cosmetic procedures.
News
One year on since PiP breast implant scare. One
year on since the serious problems with PiP breast implants
emerged, almost 8,000 women, who had their implants put in
privately, have turned to the NHS for help. The latest figures show
that, up to 30 November a total of 7,917 referrals have been
received from women who had their implants put in privately. The
NHS stepped in when it became apparent that some private clinics
wouldn’t support their patients or had collapsed so women had no
way of getting help. Worried women were offered the opportunity to
have a consultation, a scan and, if agreed it would be the best
thing for their health, the NHS would remove the implants.
New rules will force hospitals to publish operation
survival rates by individual surgeons. Hospitals will be
required to publish survival rates for operations by individual
surgeons under rules to be announced on December 18, 2012 by the
independent NHS Commissioning Board.
GMC launches confidential helpline for doctors to raise
concerns about patient safety. The General Medical Council has
launched a new confidential helpline for doctors to voice concerns
about patient safety. The new service is part of the GMC's
commitment to try and support doctors who raise concerns around
patient safety and to promote a more open and transparent working
culture. The Confidential Helpline number is: 0161 923 6399.
Thalidomide survivors given ten-year
settlement. The Government has announced a new settlement for
the survivors of the thalidomide scandal to help with increasing
health costs. The Department of Health will disburse about GBP 80
million over the next decade to 325 surviving victims in England,
whilst survivors in Scotland will share GBP 14.2 million.
Failure to diagnose leads to accountability
test. This report in the Guardian notes that a nurse and one of
the UK's largest out-of-hours providers of GPs are being sued for
£250,000 by the family of a young woman who died because of their
failure to diagnose her fatal condition. Neither the firm,
originally part of Harmoni before being acquired by Care UK in
November 2012, nor the nurse involved are willing to accept
liability for the error. This is a test case for where culpability
will lie in a service that is increasingly provided by private
providers.
If you wish to discuss any of the items raised in this section please contact Joanna Lloyd or Julie Chappell.
Commissioning
Publications/Guidance
The Public Services (Social Value) Act 2012 -
Advice for commissioners and procurers(Procurement Policy Note
10/12). This Cabinet Office PPN advises commissioners and
procurers on how they must follow the 2012 Act and take it into
account when considering procurements on how they must follow the
2012 Act and take it into account when considering procurements of
certain types of services contracts and framework agreements.
The social value guide. This guide is designed
to help with embedding social value in commissioning and
procurement practices. It aims to help those public bodies who are
affected by the Social Value Act prepare for its implementation in
January 2013.
Consultations
Consultation on service specifications and clinical
policies. The NHS Commissioning Board is seeking views on 120
draft service specifications and 43 underpinning clinical
commissioning policies for specialised services commissioning that
have been developed by Clinical Reference Groups, which define what
the NHS CB expects to be in place for providers to offer
evidence-based, safe and effective services. They are grouped into
five Programmes of Care: Internal medicine (digestion, renal,
hepatobiliary, and circulatory system); Cancer and blood
(infection, cancer, immunity and haematology); Mental health;
Trauma (traumatic injury, orthopaedics, head and neck, and
rehabilitation); and Women and children (women and children, and
congenital and inherited diseases). The NHS CB now wants to test
them further with more stakeholders to ensure that there are safe
and effective services in place from 1 April 2013. The consultation
closes on 18 January 2013.
If you require further information about any of the items raised in this section please contact David Owens.
Back to top
Complaints
News
Doctor under fire for alleged errors prescribing
sex-change hormones. The Guardian reports that a woman who
alleges that she was inappropriately prescribed sex-changing
hormones and then wrongly underwent a double mastectomy is one of
several complaints being investigated by the General Medical
Council about the doctor who oversaw her aborted gender
reassignment.
If you wish to discuss the item raised in this section please
contact Julie
Chappell.
Employment/HR
Publications/Guidance
Review Body on Doctors’ and Dentists’ Remuneration:
Review of compensation levels, incentives and the Clinical
Excellence and Distinction Award schemes for NHS consultants.
This report by the independent expert pay review body recommends
changes to consultant contracts and clinical excellence awards so
that they better recognise current excellence in providing high
quality patient care, medical teaching and research. The Government
has accepted the main recommendations and observations expressed in
the independent report as a basis for discussion, and will now
begin active engagement with the medical profession and NHS
Employers about how to take things forward.
Scoping report on the contract for doctors in
training. NHS Employers carried out a scoping exercise in
response to a request from the Review Body on Doctors’ and
Dentists’ Remuneration (DDRB). The current contract was introduced
12 years ago and the report concludes that it no longer works
effectively for junior doctors or their employers. Particularly
problematic elements of the current contract include: the effect it
has on the employment relationship; the rigidity of shift patterns;
pay protection (both banding and career grade salary protection);
monitoring; and the re-banding process. This report highlights the
need for: more flexible working patterns and better training; a
single contract for trainees; and more support for doctors’
work/life balance.
NHS lone worker services framework agreement. This letter provides information in relation to concerns which have arisen regarding early terminations of NHS lone worker services framework agreements.
NHS Employers scoping report on the contract for doctors in training. The NHS Employers scoping report on the contract for doctors in training provides a basis for discussions with the medical profession about how it can ensure national medical contracts that are affordable and fit for purpose for staff, employers and patients.
Letter on pensions for public health staff transferring to local authorities. This letter provides an update on the treatment of pensions after 1st April 2013 in relation to the transfer of public health staff to local authorities.
Supplementary evidence for the review body on doctors' and dentists' remuneration: review for 2013. This scoping report on the contract for doctors in training and command paper provides a basis for discussions with the medical profession about how we can ensure national medical contracts that are affordable and fit for purpose for staff, employers and especially patients. The report outlines a case for the need to provide doctors who are completing specialist training a clearer career path; to reward excellence and promote high quality care; and to support the move towards more consultant-delivered care.
Bevan Brittan Events
Workforce Forum: Your Medical Workforce - Improving Performance
Management and Minimising Legal Challenges. 07 February 2013 :
6pm - 7.30pm (Registration at 5.30pm). Location: Birmingham. We are delighted to announce our
first Workforce Forum in the Birmingham office of Bevan Brittan
LLP. Our forums involve the combination of brief
presentations from high-level speakers, from both the private and
public sectors, within an informal environment, where everyone is
able to ask questions and make their own contributions. The
sessions provide an excellent opportunity to exchange views, share
knowledge and network with peers and other senior individuals
within the NHS workforce landscape.
Bevan Brittan Updates
Employment Eye: News Round-up. This month, the plums in our
Christmas employment news pudding are: ‘law in a cold climate’
(dealing with severe weather related absence); next year’s
statutory payment rates and limits; DH guidance on staff transfers;
and an update on the review of the Public Sector Equality
Duties. And Stop Press - Government announces
reduced collective redundancy consultation period. Sarah
Maddock reports.
If I’ve told you once, I’ve told you twice…a misconduct update. John Moore reports on two recent decisions which provide useful, practical points on dealing with misconduct dismissals.
Lessons from Mid Staffordshire – What does the board of a health organisation need to know? Robert Francis QC’s report into the Mid Staffordshire Inquiry is due to be issued to the Secretary of State in January 2013. Whilst the Inquiry’s detailed findings and recommendations are awaited, an examination of the evidence identifies a range of themes to which the sector should have regard in anticipation of the final report and beyond. In this alert, we focus on the theme of the effectiveness of provider boards.
The law of unintended consequences: TUPE service provision changes. What happens if an outsourced contract expires and is brought back in-house to be run as a skeleton service, pending a new contractor being appointed to take over the outsourced contract? Would this amount to a ‘service provision change’ under TUPE, despite the fact that the client had never intended to run the service itself? Sarah Lamont considers this question in the light of a recent decision from the Employment Appeal Tribunal.
If you require further information about any of the items raised in this section please contact Julian Hoskins or James Gutteridge.
Estates and FacilitiesPublications/Guidance
Review of NHS structure critical infrastructure
risk. This letter was sent to NHS organisations who have been
invited to participate in the review of the NHS's recurrent report
for of a need for significant investment in maintenance of its
facilities. This is intended to eliminate 'critical risks' to the
safety of patients, visitors and staff; and the resilience of its
services.
If you require further information about any of the items raised in this section please contact Rob Harrison or Mark Calverley.
Back to top
Finance
Publications/guidance
Progress in making NHS efficiency savings. This
report finds that the NHS made a substantial amount of efficiency
savings in 2011-12. It argues that these savings will need to be
sustained and built on in future years if the NHS is to generate up
to £20 billion of savings in the next four years.
Adults' personal social services: specific revenue
grant and capital grant allocations for 2013/14 & 2014/15. This
letter sets out the provisional adults’ personal social services
specific revenue and capital grant funding for local authorities
for the periods 2013/14 and 2014/15. Details of individual funding
stream allocation formulae (where these are available), and a brief
description of each area, appear in the relevant annexes.
Funding transfer from the NHS to social care in
2013/14 - what to expect. This letter provides provisional
information on the transfer of £859m in 2013/14 to from the NHS to
local authorities.
Accountable officer and director of finance roles for the financial closedown of PCTs. This letter from Janet Perry, NHS Chief Financial Controller, provides an update for NHS Commissioning Board Local Area Team Directors regarding the financial closedown of PCTs. It outlines the accountability arrangements for the 2012/13 financial accounts, and their role in managing the discharge of balances transferred to the department in early 2013/14.
Bevan Brittan Events
Project
Finance 2. 17 January 2013 : 3:00pm to 5:00pm (Registration
from 2:30pm). Location:
Bevan Brittan, Fleet Place House, 2 Fleet Place, Holborn Viaduct,
London, EC4M 7RF. Bevan Brittan invites you to a seminar on
'Private Finance 2' (PF2). The Government wants
PF2 to become an enduring part of public service and infrastructure
provision for years to come and has recognised the benefits of PFI
while seeking to address some of the issues that have generated
negative publicity. The new published
Standardisation of PF2 Contracts therefore places great weight on
enhancing transparency of arrangements between the public and
private sectors and driving value for money, in part to attract new
funding streams, through adjustments to the risk profile.
If you wish to discuss any of the items raised in this section please contact David Owens.
Back to topFoundation TrustsPublications/guidance
Amendments to 'Applying for NHS Foundation Trust
status - Guide for Applicants' (January 2013) The updates made
to the Guide have been made to take account of Monitor's recent
consultation on changes to the Guide for
Applicants and changes resulting from the Health and Social Care Act (2012), e.g. the
removal of the private patient income cap; and to provide a range
of updates and clarifications to Monitor's process. A further
update to the guide will be made in spring 2013 to reflect
additional changes resulting from the legislation and Monitor's
consultation on the Risk Assessment Framework,
which will replace the Compliance Framework later in 2013/14. Any
changes which may result from the Mid Staffordshire NHS Foundation
Trust Public Inquiry will be incorporated into guidance as
necessary.
Consultation
Consultation on proposed changes to Quality Report
requirements for 2012/13. This consultation sets out Monitors
proposals to make changes to the Detailed Guidance for External
Assurance on Quality Reports. The proposals include changing
the mandated indicators for acute foundation trusts and
standardising and mandating the local indicator for all foundation
trusts. Closing date : 31/01/2013.
News
Mid-Staffordshire NHS Foundation Trust
'unsustainable.' A hospital trust accused of appalling
standards of care three years ago is unsustainable in its current
form, say independent experts.
Bevan Brittan Articles
The Mid-Staffordshire NHS Foundation Trust Public Inquiry -
Organisational Culture and Quality Governance. In this alert,
we focus on the related quality governance themes of organisational
culture and the structures for quality governance and learning to
enable organisations to consider these and possible future
developments in advance of the Inquiry’s report.
Lessons from Mid Staffordshire – What does the board of a health organisation need to know? Robert Francis QC’s report into the Mid Staffordshire Inquiry is due to be issued to the Secretary of State in January 2013. Whilst the Inquiry’s detailed findings and recommendations are awaited, an examination of the evidence identifies a range of themes to which the sector should have regard in anticipation of the final report and beyond. In this alert, we focus on the theme of the effectiveness of provider boards.
If you require further information about any of the items raised in this section please contact Vincent Buscemi.
Back to topInformation and Data SharingPublications/Guidance
Number of GPs calling for advice on parental
requests for children's medical records rises. GPs are
increasingly getting caught in the crossfire between divorced or
separated parents who want access to their children's medical
records, experts have revealed. The Medical Protection Society, one
of the world's leading medical defence organisations, says there
has been a steep increase in calls from GPs concerned about
requests for access to children's medical information from
separated parents. The MPS has had 800 calls over the past five
years, with 179 of them in the last year alone – equivalent to a
phone call every other day. The numbers will be just a fraction of
the total, since not all GPs belong to the MPS and many doctors
will not ask for advice on what to do.
Bevan Brittan Events
Disclosure: A refresher considering the Access to Health Records
Act 1990, Data Protection Act 1998 & Freedom of Information Act
2000. 16 January 2013 : 9.30am - 11.30am (Registration at
9.15am). Location: Bevan Brittan LLP, Fleet Place House, 2 Fleet
Place, Holborn Viaduct, London, EC4M 7RF. We are delighted to
welcome Gerard Boyle, barrister from 3 Sergeants Inn to host a
seminar on disclosure. We will consider the disclosure issues that
you face every day in relation to requests for medical records and
information. We will look at the key provisions in the Access to
Health Records Act and Data Protection Act. The latest case law in
relation to the Freedom of Information Act will be examined along
with the key principles and obligations in respect of the
disclosure of information. We will finish the seminar with some
case studies.
If you wish to discuss any of the items raised in this section please contact Jane Bennett.
Back to top
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. 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 ask Claire Bentley. You can attend in our London, Bristol or Birmingham office.
Publications/Guidance
Safer mental health services: a toolkit.
Suicide and homicide by mentally ill people are major concerns for
mental health care providers. The National Confidential Inquiry has
made recommendations for clinical services over a number of years.
In this toolkit these recommendations have been formulated into
quality and safety statements regarding clinical, organisational
and training aspects of care. This toolkit is intended to be used
as a basis for self-assessment by mental health care providers and
responses should ideally be based on recent local audit data or
equivalent evidence.
Mental health PbR road test package for 2013/14
The Department of Health has published the components of the mental
health PbR 2013/14 “road test” package. The mental health PbR road
test package for 2013/14 includes draft guidance and support
tools.
Government publishes final report on Winterbourne
View Hospital. The Department of Health (DH) has published the
report setting out the government's final response to the events at
Winterbourne View hospital, including a programme of action to
transform services for people with learning disabilities or autism
and mental health conditions or behaviours described as
challenging. The final report into the events at Winterbourne View
Hospital states that staff routinely mistreated and abused
patients, and management allowed a culture of abuse to
grow.
Transforming care: A national response to
Winterbourne View Hospital. The government has published its
final report into the events at Winterbourne View Hospital and has
set out a programme of action to transform services so that
vulnerable people no longer live inappropriately in hospitals and
are cared for in line with best practice.
The programme of action includes:
by Spring 2013, the DH will set out
proposals to strengthen accountability of boards of directors and
senior managers for the safety and quality of care which their
organisations provide;
by June 2013, all current placements
will be reviewed, everyone in hospital inappropriately will move to
community-based support as quickly as possible, and no later than
June 2014;
by April 2014, each area will have a
joint plan to ensure high quality care and support services for all
people with learning disabilities or autism and mental health
conditions or behaviour described as challenging, in line with best
practice as a consequence, there will be a dramatic reduction in
hospital placements for this group of people;
the Care Quality Commission will
strengthen inspections and regulation of hospitals and care homes
for this group of people, including unannounced inspections
involving people who use services and their families; and
a new NHS and local government-led
joint improvement team will be created to lead and support this
transformation.
This programme is backed by a concordat signed by more than 50
partners, setting out what changes they will deliver and by when.
The Government will publish a progress report on these actions by
December 2013.
The final report into the events at Winterbourne View Hospital
states that staff routinely mistreated and abused patients, and
management allowed a culture of abuse to flourish. The warning
signs were not picked up, and concerns raised by a whistleblower
went unheeded. The report also reveals weaknesses in the system’s
ability to hold the leaders of care organisations to account. In
addition, it finds that many people are in hospital who don’t need
to be. People with learning disabilities or autism, who also have
mental health conditions or challenging behaviour can be, and have
a right to be, given the support and care they need in the
community, near to family and friends.
The Care and Support Minister Norman Lamb has made a
commitment to move out of long stay hospital every person with
a learning disability or autism who does not need to be there. He
has pledged to set out plans for holding Boards of Directors to
account for poor care and failing standards, saying that there is a
national imperative to act decisively and end the scandal of poor
care. A comprehensive, timetabled programme of action to drive
forward improvement in services has been agreed. 50 groups,
covering a wide range of organisations involved in the care and
support of people with learning disabilities and autism, have
signed up to a Concordat that will set out these goals. Norman Lamb
will personally chair a board to oversee progress. The DH will
report on progress by December 2013.
Power of attorney applications lead MoJ's digital dash. The
Ministry of Justice has announced that applications for lasting
power of attorney will be available on the internet from April 2013
as one of a batch of digital services that will also involve the
introduction of the following: an online process for making civil
claims; online payments of the new fees for employment tribunals;
and online bookings for prison visits by pre-approved members of
the public.
Drugs and alcohol Payment by Results (PbR) pilot
evaluation: scoping and feasibility report. This report,
commissioned by the Department of Health, looks at a pilot project
which took a new approach to commissioning and delivering drug and
alcohol misuse treatment.
A future state of mind: facing up to the dementia
challenge. This report draws on in-depth interviews with people
with Alzheimer's and their carers and a wealth of research to
identify the barriers to early diagnosis, from a patient and
professional perspective. New policies are proposed to better
incentivise the health system to diagnose dementia earlier.
Consultations
Liberating the NHS: No decision about me without me
– Government response. This response to the consultation on
proposals for greater patient involvement and more choice outlines
how patients will be able to choose from any provider in England
when they are first referred to see a specialist in secondary care.
In addition, the response outlines plans more broadly to increase
patient involvement in decisions about their care and treatment and
to increase patient choice. For the first time, people who use
mental health services will get more choice about where and how
they get their condition treated by the NHS.
The DH has also published a digital map and list of organisations that will
be providing NHS community services locally and what services they
will offer to local patients.
Department announces pilot projects to improve
severe mental illness services. Care and Support Minister
Norman Lamb has announced that 6 local projects have begun work to
help improve access to psychological therapies for those with
severe mental illnesses. The 6 NHS demonstration sites are already
leaders in the mental health field and have been chosen to
implement the National Institute of Clinical Excellence’s
recommended psychological therapies.
Cases
J Council v GU (by his litigation friend, the
Official Solicitor) [2012] EWHC 3531 (COP). The Court of
Protection approved an agreed final order requiring the patient to
live at a care home. The court held that in the circumstances, the
interferences with G's private life, which included monitoring his
correspondence and telephone calls, were in compliance with Art.8
ECHR.
An NHS Trust v DJ (by his litigation friend, the
Official Solicitor) [2012] EWHC 3524 (COP). The Court of
Protection held that it would not be appropriate to make the
declaration sought by the application NHS trust and that the
withholding of the stated treatments would not be in the patient's
best interests.
News
Department of Health and NHS investigations into
Jimmy Savile. The DH has outlined the terms of reference for
the investigations into the alleged abuse by Jimmy Savile at
Broadmoor Hospital, Stoke Mandeville Hospital and the Leeds General
Infirmary. Former barrister Kate Lampard is to provide independent
assurance of the existing investigation process. The investigations
are expected to be completed towards the second half of 2013.
Government backs businesses with £5 million funding
boost. Announces £5m of funding for businesses to come up with
new products or services that will help improve the experience of
people with mental health illnesses and people at the end of their
life. This funding is part of the Government’s commitment to help
improve care for patients with long-term conditions and ensure high
quality care and support offered to dying people in their final
days and hours. The application process for both of the two new
competitions is being run through Health Enterprise East, the NHS
Innovation Hub for the East of England. All applications should be
made using the application forms, which can be downloaded from the
Health Enterprise
East website. The closing date for applications is 28 February
2013.
More choice in mental health. For the first
time, people who use mental health services will get more choice
about where and how they get their condition treated in the
NHS.
Jail sentence for mentally ill man quashed A
man with a mental illness who set fire to a hospital door in an
attempt to escape his psychiatric ward has had his sentence reduced
from an indefinite prison sentence on the grounds of public
protection to a hospital order.
If you wish to discuss any of the items raised in the above section please contact Simon Lindsay.
Back to topObesityPublications/Guidance
Action on obesity: comprehensive care for all.
This report from the RCP outlines the issues around obesity in the
UK, including the variations in treatment across the country, the
related health issues, and the wider impact on public health.
News
Overweight people who refuse to complete exercise
prescribed by doctors could have their benefits reduced under
proposals by Westminster City Council. Responsibility for
"community wellbeing and public health" is being transferred to
local authorities under reform of the benefits system.
If you require further information about any of the items
raised in this section please contact
Julie Chappell.
Primary Care
Publications/Guidance
First GP groups given green light to take control
of NHS budgets. The NHS Commissioning Board has announced the
authorisation of the first wave of 34 new Clinical Commissioning
Groups (CCGs) that will take control of the NHS budget in their
area to commission healthcare services for their communities.
Determining arrangements for supporting research in
primary and community care: discussion paper. This paper aims
to support local organisations, in collaboration with local
networks, to consider how to achieve a smooth transfer of
capability within the changing NHS for supporting primary and
community care research.
Securing Excellence in IT Services. The NHS Commissioning Board has
published frequently asked questions and a factsheet to accompany the recently published
primary care IT operating model.
Hepatitis B and C: ways to promote and offer testing to people at increased risk of infection. This advice tool considers implementation issues that are specific to the published guidance. It provides practical suggestions for action to help those responsible for planning and implementing staff training. It is aimed at commissioners, service leads and others providing training for professionals working with people at increased risk of infection. The latest pathway on hepatitis B and C aims to ensure more people who are at increased risk of infection are tested, and says GPs and practice nurses should offer testing for hepatitis B and C to adults and children at increased risk of infection.
Consultations
General Medical Services - Contractual changes
2013/2014. Seeks views on proposed changes to the GP contract,
which will see: GPs rewarded for earlier diagnosis and better care
of dementia patients and patents with long term conditions; and a
new vaccination and immunisation programme for rotavirus and
shingles from 1 September 2013. The closing date for comments is 26
February 2013.
News
A new telehealth video from the Royal College
of General Practitioners (RCGP) highlights some of the key reasons
why clinicians are recommending telehealth for their
patients.
If you wish to discuss any of the items raised in the above section
please contact
David Owens.
Public Health
Publications/Guidance
A dose of localism – The role of councils in public
health. This joint report from the LGiU and Westminster City
Council examines the role of councils in promoting public health.
It discusses how local government is receiving responsibility for
public health at a challenging time, when it is facing both a
significant increase in demand and a significant reduction in
resource. It makes five recommendations as to how local authorities
can integrate public health across all service areas, help
communities to provide services for themselves and invest in
prevention. In particular, it highlights the need for councils to
incentivise people to exercise.
Public Health England: code of conduct for
staff. This code of conduct, announced by Chief Executive
Designate Duncan Selbie, has been agreed for staff of Public Health
England.
Local Healthwatch regulations: a summary report of
engagement - addendum. This addendum covers issues around the
local Healthwatch regulations and provides information on the
Department’s approach to the drafting of regulations in response to
the views received from the six week consultation.
News
More control given to councils to scrutinise
changes to local healthcare. The Health and Social Care Act
2012 will come into force in April 2013 extending the scope of
health scrutiny to include all NHS and public health services. New
regulations on local authority health scrutiny are being prepared
to ensue that any changes to local healthcare are more transparent
and overseen and considered locally.
If you wish to discuss any of the items raised in the above section please contact Olwen Dutton.
Back to topRegulation
Publications/Guidance
Government response to the Science and Technology
Select Committee report on the regulation of medical implants.
The Medicines and Healthcare Products Regulatory Agency has
published the government's response to the Science and Technology
Select Committee report on the regulation of medical implants. The
government believes there should be tighter controls on notified
bodies, better post-market surveillance of medical devices and more
collaboration between national regulators. Broadly, the government
agrees the best way to improve the safety of medical implants is to
build on the current regulatory framework.
Consultation
Draft enforcement guidance: consultation
document. Seeks views on draft guidance that sets out Monitor's
general approach to exercising its enforcement powers in relation
to potential and actual breaches of the licence and other
regulatory obligations. The consultation closes on 11 February
2013.
Cases
Houshian v General Medical Council [2012] EWHC 3458
(QB) (QBD). The court held that the GMC's Interim Orders Panel
had erred in suspending a doctor's registration for 18 months
pending the determination of his fitness to practise after an
employment tribunal had found that he had fabricated evidence in an
unfair dismissal claim. The suspension was not a proportionate
response since the Panel had failed to identify a serious risk to
the public if the doctor was allowed to continue to work with
patients.
If you wish to discuss any of the items raised in this section please contact Carlton Sadler.
Back to top
General
Publications/Guidance
Seven day Consultant Present care. This report
from the Academy of Medical Royal Colleges, which brings together
20 colleges and faculties, outlines its commitment to delivering
high quality care to patients seven days a week. The publication
recommends three key standards to ensure all patients receive high
quality care led by a consultant regardless of the day of the
week:
hospital inpatients should be reviewed
by an on-site consultant at least once every 24 hours, seven days a
week, unless it has been determined that this is not necessary for
the patient;
consultant-supervised interventions
and investigations along with reports should be provided daily if
the results will change the outcome or status of the patient’s
overall care before the next ‘normal’ working day. This should
include interventions which will enable immediate discharge or a
shortened length of stay; and
setting should be available daily to
ensure that the next steps in the patient’s treatment, as
determined by the daily consultant review, can be taken. It also
acknowledges that it is outside its scope to look in detail at
community services.
Securing sustainable NHS services - The Trust
Special Administrator’s report on South London Healthcare NHS Trust
and the NHS in south east London. The Trust Special
Administrator Matthew Kershaw was appointed in July 2012 under the
Regime for Unsustainable NHS Providers – the first time the regime
has been used since it was introduced in 2009. The Administrator
was appointed to develop recommendations under a time-limited
framework for addressing the Trust’s significant financial problems
and ensuring high-quality care for the people of SE London in the
long term. This final report makes recommendations in relation to
the South London Healthcare NHS Trust to secure sustainable
provision of health services to those patients served by the trust
and in the south east London health economy. The Secretary of State
will now consider the final recommendations made to him and make
his decision by early February that can secure sustainable services
for the people of SE London.
Accident and emergency 2012. This report
outlines the results of a survey on people's experiences of
treatment on A&E departments. The results of this survey can be
used by members of the public to help them find out how well
A&E departments in the NHS are performing. NHS trusts can also
use them to improve their own performance. The results will also
feed into the CQC quality and risk profiles which contribute to
inspections of health services.
Hospital Pathways programme: lessons learned.
This article tells the story of the Hospital Pathways programme, a
collaborative programme in which five acute trusts worked with The
King's Fund and the Health Foundation to apply techniques, not
widely used in the NHS, to improve both processes of care and
interactions between staff and patients. It describes the
programme; the method used to evaluate it; what was learned about
the approach, and how the lessons have influenced the next
programme called Patient and Family-Centred Care.
Making integrated out of hospital care a
reality This report discusses the foundations for integrated
care for adults, children and young people, with a focus on
implementing out of hospital care, and connecting primary,
community and social care. It highlights key evidence and draws on
learning from partners across health and social care.
Improving outcomes: a strategy for cancer - second annual report 2012. This report demonstrates that cancer survival rates are improving. It is published alongside a report of the first pilot survey of cancer survivors, in which people with specific cancers were asked about their quality of life after diagnosis. This report is aimed at commissioners, commissioning support units and providers to help them understand how to continuously improve after-care for cancer survivors.
Everyone counts: planning for patients 2013/14. This planning guidance aims to help local clinicians deliver more responsive health services, focused on improving outcomes for patients, addressing local priorities and meeting the rights people have under the NHS Constitution. It outlines the incentives and levers that will be used to improve services from April 2013, the first year of the new NHS where improvement is driven by clinical commissioners.
'Friends and family' test to expose poor care in NHS. The Prime Minister has announced that a new ‘friends and family’ test – where patients and staff are asked whether they would recommend the service to a loved one – will be introduced into every hospital in England from April 2013. He wants that to go further, with GP surgeries, district nursing and community hospitals all adopting the measure. The announcement builds on the recently published ‘Compassion in Practice’ vision for nursing, midwives and care staff, which sets a blueprint for respectful and dignified care across the NHS.
Care in local communities: A new vision and model for district nursing. This document sets out the strong foundations of district nursing services, and outlines the developments and innovations that ensure services can meet current and future needs.
The Coalition – Together in the national
interest. The Coalition Government has published its Mid Term
Review that takes stock of progress made in implementing the
Coalition Agreement signed in May 2010. The Review mainly lists
what the Government has done so far to implement its policies to
build a stronger, more balanced economy and a fair society. It also
highlights what it claims are a "new set of reforms" to secure the
country’s future and help people realise their ambitions. These
include:
setting an ambition for the NHS to put
mental health on a par with physical health, significantly
improving access and waiting times for all mental health services,
and reducing the incidence and impact of
post-natal depression through earlier diagnosis and better
intervention and support;
implementing a strategy aimed at
building a culture of compassionate care for nursing, midwifery and
care staff;
consulting on further measures to
protect people who rely on care services where the provider fails
in England;
threshold to make access to care more
consistent across England;
introducing a Universal Deferred
Payments scheme so that nobody will need to sell their home to pay
for the costs of residential care in England;
providing £100m for NHS nurses and
midwives to spend on new technology to free up time for patient
care and make essential patient details instantly available on the
ward;
continued support for the creation of
mutuals and co-operatives, and continued development of Right to
Provide policies that will enable mutual and co-operative
organisations to deliver a wider range of public services;
legislating to give people with
eligible needs for care an entitlement to a personal budget and a
care and support plan in England; and
each public body will be reviewed once
every three years to ensure that it can justify to Ministers its
existence and structure.
Detailed plans for public spending for the 2015/16 fiscal year will
be set out before Summer 2013, in line with the overall path of
deficit reduction which has already been set out to 2017/18.
Liberating the NHS: no decision about me without me
- Government response. This publication outlines the
Government's response to a consultation on proposals for greater
patient involvement and choice. It outlines how patients will have
a choice in provider when they are first referred to see a
specialist in secondary care. It also outlines broader plans to
increase patient involvement and patient choice.
Getting started: prospects for health and wellbeing
boards. This report suggests that the new health and wellbeing
boards could improve integrated care, provide a more democratic
approach and help develop a shared plan for their local
populations. It emphasises that building good relationships and
adequate resources will be required if they are to be
effective.
Developing and updating local formularies. This
guidance provides advice and guides good practice for those
involved in handling, prescribing, commissioning and
decision-making about medicines. It has been designed to help
organisations develop and update local formularies that reflect
local needs, reduce variation in prescribing, and allow rapid
uptake of innovative medicines and treatments, in accordance with
statutory requirements.
Digital strategy: leading the culture change in
health and care published. This strategy sets out plans for the
Department of Health to become a Digital First department of state,
with digital tools and techniques embedded throughout its work. It
outlines the department's commitments to increase the effectiveness
of engagement with stakeholders; improve the development of
policymaking; and steward the health and social care system towards
a health information revolution.
Cancer services coming of age: learning from the improving cancer treatment assessment and support for older people project. This report summarises a series of pilots that tested whether appropriate assessment of older cancer patients would result in improved access to appropriate cancer treatment, based on need and not age. It also tested whether action, as a result of an age appropriate assessment, improved the scope for older people to benefit from treatment.
Francis: the story so far. This interactive
presentation gives a brief overview of the background to the
upcoming Francis Report and the key areas which may be covered.
Interim procedures for the approval of independent
sector places for the termination of pregnancy (abortion).
These procedures set out the required standard operating principles
that approved organisations need to comply with in order to obtain
Secretary of State approval under section 1(3) of the Abortion Act
1967. They have been updated to reflect the Care Quality
Commission’s (CQC’s) regulatory framework, including other relevant
professional guidance, and should be used by all independent sector
providers of abortion services. Under the new arrangements, all
providers of regulated activities must meet the relevant outcomes
set out in the CQC’s guidance on essential standards of quality and
safety.
Creating change: Innovation health and wealth one
year on. Provides an update on the implementation of the NHS
Chief Executive’s report "Innovation health and wealth,
accelerating adoption and diffusion in the NHS" (December 2011).
The first report set out delivery for spreading innovation quickly
and at a scale throughout the NHS. This new report demonstrates the
progress that is being made at a time of great change in the NHS.
It highlights what more should be done to deliver the improvements
needed to fully embrace and embed innovation in the NHS and improve
outcomes and quality for patients and the NHS and drive growth for
the UK.
Improving the use of medicines for better outcomes and reduced waste: an action plan. This report looks at ways of improving the use of medicines and tackling avoidable wastage in primary and community care, secondary care, and in care homes and end of life care. It also looks at how patients can be better engaged in decisions about their medicines as well as how information can be better provided to patients and health and care professionals. The action plan outlines how best practice could be shared across the NHS in the future.
Cases
R (Tracey) v (1) Cambridge University Hospital NHS
Foundation Trust (2) Secretary of State for Health; Equality &
Human Rights Commission (Interested Party) [2012] EWHC 3670 (Admin)
(Admin Ct). Following a determination of disputed issues of
fact in a claim for judicial review of a hospital's policy in
respect of non-resuscitation orders, the court decided that a
further substantive hearing would not be appropriate or
proportionate. Although there was a wider public interest in such a
hearing, public interest would not be served by a wide-ranging
enquiry based on limited findings of fact.
Legislation
Common rules on medical prescriptions when
travelling to another EU country. The European Commission has
adopted EU-wide rules on a minimum list of elements to be included
in medical prescriptions taken by a patient travelling from one EU
member state to another. Member states must implement the
provisions into national law by 25 October 2013. The rules are
intended to allow for the easy identification of the patient, the
prescriber and the prescribed product.
Consultations
Consultation on service specifications and clinical
policies. The NHS Commissioning Board is seeking views on 120
draft service specifications and 43 underpinning clinical
commissioning policies for specialised services commissioning that
have been developed by Clinical Reference Groups, which define what
the NHS CB expects to be in place for providers to offer
evidence-based, safe and effective services. They are grouped into
five Programmes of Care: Internal medicine (digestion, renal,
hepatobiliary, and circulatory system); Cancer and blood
(infection, cancer, immunity and haematology); Mental health;
Trauma (traumatic injury, orthopaedics, head and neck, and
rehabilitation); and Women and children (women and children, and
congenital and inherited diseases). The NHS CB now wants to test
them further with more stakeholders to ensure that there are safe
and effective services in place from 1 April 2013. The consultation
closes on 18 January 2013.
News
DNA tests to revolutionise fight against cancer and
help 100,000 NHS patients. £100 million will be invested in
sequencing the genome of 100,000 cancer patients within the NHS,
the Prime Minister has announced. The patients' genomes will be
sequenced over the next three to five years, beginning within the
next 12 months. The research is intended to provide doctors with
new and detailed understanding of a patient's genetic makeup and
treatment needs.
A widow has been granted leave to continue her late
husband’s challenge to the existing law on murder and assisted
suicide. The family of Tony Nicklinson, the
locked-in syndrome sufferer who died in August 2012, has gained
permission to continue his right-to-die campaign and appeal against
the High Court ruling which went against him. The Court of
Appeal has made an order that Jane Nicklinson as the administrator
of her late husband Tony’s estate, may take forward his case that
the current law was incompatible with his rights under Article 8 of
the European Convention on Human Rights.
Terminally ill woman not consulted on hospital resuscitation order: family of 63-year-old who received medical notice on Addenbrooke's ward want patient rights clarified. On December 21, 2012 the High Court will rule on whether the legal issues in the case of terminally ill Janet Tracey, who was not consulted before a notice instructing "do not resuscitate" was placed with her medical records, should be considered at a judicial review hearing in February 2013. Tracey's family want to clarify the law over the notices and make the Department of Health maintain a national policy on the issue.
Bevan Brittan events
Project
Finance 2. 17 January 2013 : 3:00pm to 5:00pm (Registration
from 2:30pm). Location:
Bevan Brittan, Fleet Place House, 2 Fleet Place, Holborn Viaduct,
London, EC4M 7RF. Bevan Brittan invites you to a seminar on
'Private Finance 2' (PF2). The Government wants
PF2 to become an enduring part of public service and infrastructure
provision for years to come and has recognised the benefits of PFI
while seeking to address some of the issues that have generated
negative publicity. The new published
Standardisation of PF2 Contracts therefore places great weight on
enhancing transparency of arrangements between the public and
private sectors and driving value for money, in part to attract new
funding streams, through adjustments to the risk
profile.
If you wish to discuss any of the items raised in this section
please contact Claire
Bentley.
