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   Governance
  Children   Information and Data Sharing
  Clinical Risk/Health and Safety   Mental Health
  Commissioning   Obesity
  Complaints   Primary Care
  Employment/HR   Public Health
  Finance   Regulation
  Foundation Trusts   General 



Current and future needs for hospice care: an evidence-based report. This report from the Commission into the Future of Hospice Care focuses on crucial factors for hospice care planning in the UK. It provides strategic direction for providers of hospice care in the UK for the next 10 to 15 years. It presents the current evidence on preferences for place of care and place of death in the UK. It shows that most people would prefer to die at home, but also that there is a substantial proportion who would prefer to die in hospices or palliative care units, particularly among older people.

The future of health and social care timeline. The King's Fund has produced a timeline that picks out some of the key trends that will affect how health and social care is delivered over the next 20 years. There is also an overview of future trends that gives a summary of the most significant trends and drivers that the King's Fund believes will affect health and social care services over the next 20 years.

R (Redcar and Cleveland Independent Providers Association) v Redcar and Cleveland BC [2013] EWHC 4 (Admin) (Admin Ct). The Administrative Court has granted an application for judicial review of the Council's decisions to set the rates which it would pay care homes for wholly or partly funded residents for 2012/13 that were below that which they paid the previous year, and to remove from its provider list all care home operators who did not agree to accept the Council's new contractual framework by 23 April 2012. An organisation that represented care home owners in the area contended that the Council had failed to assess and have due regard to the actual costs of providing care and other local factors under statutory guidance and that the Council could not maintain a closed list of care homes in which it would place residents. The Council submitted that the issues in the case were not amenable to judicial review because they concerned the terms upon which a party was willing to enter into private law contractual arrangements and it owed no statutory duties to care home providers.
The court held that in order to attract public law remedies, the applicant did not have any private law remedy as the Council was merely setting out the terms upon which it was prepared to contract with the providers in future and there was no existing contract that the Council could be alleged to be in breach of. The complaint in this case was about the price, which was set pursuant to public law powers and guidance. The Council had had regard to both the 2011/12 fee rates and the benchmarked figures not with a view to ascertaining and having due regard to the actual costs of care but more with a view to calculating what reduction might be possible to negotiate from or impose upon providers in an attempt to avoid judicial review proceedings. It had therefore failed or failed properly to assess and have due regard to the actual costs of care in particular in relation to local factors. The Choice of Accommodation Directions required the Council to enter into arrangements with any care home chosen by a prospective resident, providing the relevant conditions were met at the time, although the Council could insist that the provider entered into contractual arrangements on its standard terms and the provider could not expect to recover more than the usual fee unless there were exceptional arrangements. So RCIPA's homes might be on a list that the Council was prepared to contract with but contracts would only be actually entered into if RCIPA was prepared to sign the framework agreement.

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

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Useful resources for health visitors. These resources and tools are aimed at health visitors and people who work with them to deliver the Healthy Child Programme for children aged 0 to 5 years old. They include professional pathways, guidance and education and training resources, as well as factsheets and questions and answers (Q and A).

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

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Clinical Risk/Health and Safety     

Report into fire safety duties in the NHS. Deputy NHS Chief Executive David Flory has written to colleagues highlighting the main findings from a report by the Fire and Rescue Service (FRS), into fire safety in the NHS. The report follows a fire incident at a hospital in October 2011, as a result of which the FRS had planned to prosecute the NHS Trust concerned. The Department of Health decided to act on the FRS case, both to address the safety concerns raised and the issue of criminal liability following NHS trust mergers.

NHS Premises Assurance Model. The DH has issued an updated and revised version of the NHS Premises Assurance Model (PAM) tool that will help NHS providers to provide assurance to boards about locally derived estates and facilities. The DH says it should help enhance the quality and safety of NHS premises while also increasing efficiency and effectiveness. It includes updated and revised metrics and significantly revised self assessment questions (SAQs).

Estates and facilities alert. This alert relates to window restrictors that may be inadequate in preventing a determined effort to force a window open beyond the 100mm restriction. This follows an incident in which a patient died following a fall from a second floor hospital window. All healthcare organisations are asked to review the guidance.

Professional Standards for Cosmetic Practice. These guidelines published by the Royal College of Surgeons state that as standard practice, practitioners should discuss relevant psychological issues (including any psychiatric history) with the patient to establish the nature of their body image concerns and their reasons for seeking treatment. They should not at any point imply that treatment will improve a patient’s psychological wellbeing. Aimed at all doctors, dentists and nurses involved in cosmetic practice, the comprehensive document entitled Professional Standards for Cosmetic Practice, focuses on the behaviour and competencies medical professionals should be expected to demonstrate when providing cosmetic procedures. The standards, issued by the Royal College of Surgeons (RCS), state that financial deals such as time limited discounts should be banned and stringent psychological assessment promoted. They lay out the professional duty practitioners have to their patients, including the need to ensure they have a clear understanding of the risks of the procedure, outlining consequent aftercare and being transparent about costs from the outset.

NHS safety thermometer 2013/14: CQUIN guidance. Developed for the NHS by the NHS as a point of care survey instrument, the NHS Safety Thermometer provides a ‘temperature check’ on harm that can be used alongside other measures of harm to measure local and system progress. This guidance explains how this tool can be used to achieve CQUIN goals for 2013/14. It outlines a step-by-step process to aid an understanding of data, and how to use it to set improvement goals and measure improvement over time.

Quality in the new health system: maintaining and improving quality from April 2013. This report sets out how quality will be maintained and improved in the new health system. It focuses predominantly on how the new system should prevent, identify and respond to serious failures in quality, and provides a collective statement from National Quality Board members as to: the nature and place of quality in the new health system; the distinct roles and responsibilities for quality of the different parts of the system; how the different parts of the system should work together to share information and intelligence; and the values and behaviours that all parts of the system will need to display in order to put the interests of patients and the public first and ahead of organisational interests.

How to establish a quality surveillance group: guidance to the new health system. This guidance outlines the system for establishing Quality Surveillance Groups (QSGs). QSGs will be established between now and March 2013, ready to go live in the new system from April 2013. The guidance includes an assurance process, which will be rolled out between January and March 2013.

Good practice in prescribing and managing medicines and devices published by the GMC strengthens and broadens the current advice on prescribing medicines to include medical devices and gives key updates on using unlicensed medicines.

An NHS Trust v SR [2013] All ER (D) 110 (Jan). The Family Division made a declaration that the treatment package proposed by the applicant NHS Trust was lawful, in circumstances where the mother did not consent to radiotherapy treatment for her son, aged seven, who was suffering from a malignant brain tumour.

Falls: guideline consultation. A clinical practice guideline on Falls is being developed for use in the NHS in England, Wales and Northern Ireland. Registered stakeholders for this guideline are invited to comment on the provisional recommendations via this website. The consultation closes on 15 February 2013.

Medway NHS Trust fined over patient death. Medway NHS Foundation Trust has been sentenced for safety failings after a vulnerable patient died following a fall from a first floor window at Medway Maritime Hospital in Gillingham, Kent. An investigation by the Health and Safety Executive (HSE) found window had been left open, and was one of a number of windows on the ward that were unrestricted. The Trust was fined £42,000 and ordered to pay £19,073 in costs.

If you wish to discuss any of the items raised in this section please contact  Joanna LloydStuart Marchant or Julie Chappell

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Joint commissioning in health and social care: an exploration of definitions, processes, services and outcomes. This report studied examples of joint commissioning across five case study sites which all have different types of joint commissioning arrangements in place. It aimed to use practical examples in order to develop a definition of joint commissioning and to scope out the ways in which integrated commissioning can be implemented.

Implementing local diabetes networks. This report is aimed at commissioners of diabetes networks. It provides guidance and support to create local diabetes networks that deliver high-quality, cost-effective care through the effective commissioning, delivery and monitoring of services. 

Near final draft of the 2013/14 NHS standard contract. The NHS CB has published a "near final" draft of the NHS standard contract for 2013/14. The final version (for use for commissioning clinical services) and ‘e’-contract will be available on 1 February 2013, along with the final version of the technical guidance. 

Supporting planning for 2013/14 for direct commissioning. This document from the NHS Commissioning Board follows the publication of "Everyone Counts: Planning for Patients 2013/14" which outlined the incentives and levers that will be used to improve services from April 2013. It describes the processes that will be used to support planning for the next financial year. It aims to support the NHS Commissioning Board’s national, regional and area teams to ensure that every plan is as strong as it can be, by designing an approach that achieves national consistency and improves quality and equity of access to services. This should be in the context of local priorities and in conjunction with CCGs and local Health and Wellbeing Boards. 

Responses from cancer survivors survey on quality of life after diagnosis and treatment. A report summarising text responses from cancer survivors on how they feel about their quality of life following diagnosis and treatment has been published. The report is aimed at commissioners, commissioning support units and providers to help them understand how services may offer appropriate education, advice and support to the growing numbers of people who are living well, following completion of cancer treatment. 

Specialised services commissioning consultation. Seven new draft service specifications and a further clinical policy for specialised commissioning have been added to this consultation on specialised services commissioning. The service specifications and clinical policies aim to define what the NHS Commissioning Board expects to be in place for providers to offer evidence-based, safe and effective services. Responses to the consultation are invited from clinical staff, the public, patients, and groups with an interest in these specialist areas, as well as from providers and commissioners. The consultation closes on 22 February 2013.

Bevan Brittan Updates
Lessons for Commissioners - The Mid-Staffordshire NHS Foundation Trust Public Inquiry. With the final report on the Mid Staffordshire Trust due out on 6 February, it is increasingly  important for commissioners to understand the implications generally of this type of issue for them and how their role can assist in early detection and dealing with problems which can arise. 

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

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Complaint handling in NHS trusts. This report outlines the results of an analysis which shows substantial variations in the way in which hospitals display information about how to make a complaint. It also suggests that support to patients is incomplete and unclear, with 35% of staff citing insufficient training in complaints handling as an issue. Key recommendations from the report include: accessible information on how to make a complaint on trusts’ websites, as well as on leaflets and posters throughout NHS hospital ward; complaints being regarded as a learning opportunity to avoid creating a culture of blame; and specific provisions for complaint-related staff training and support.

If you wish to discuss the item raised in this section please contact Julie Chappell

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Engaging your staff: the NHS staff engagement resource. This updated toolkit includes ten new case study examples and revised text in key sections. It contains a wide range of information including an introduction to staff engagement, practical working examples, evidence on the benefits of having an engaged workforce, and access to a series of tools and resources. It is aimed at all staff groups, from clinicians, HR managers and communications teams to senior managers.

HR and social media in the NHS. This guidance explains that social media is increasingly becoming central to the ongoing effectiveness of the NHS. It argues that there is a need for a more open approach alongside greater clarity on professional behaviour and the importance of confidentiality. The guidance provides examples to help human resources managers, leaders and communications staff use social media more effectively within their organisations.

National mobile health worker project. This study aimed to better understand the requirements of mobile working, and to demonstrate whether increased productivity and efficiency can be achieved by making changes to working processes. The final report outlines the benefits of mobile technology for health staff and patients at 11 NHS pilot sites. Key findings include: significant increases in productivity; an increase in available time for patient contact; reductions in unnecessary journeys as well as time spent travelling; and significant reductions in data duplication.

Improving workforce motivation and productivity. Better health outcomes for patients will only be achieved if hospitals focus on their staff, according to report from KPMG. This report argues that insufficient attention is being paid to the changing relationship between clinicians and their patients.

R (T) v (1) Chief Constable of Greater Manchester (2) Secretary of State for the Home Department (3) Secretary of State for Justice; Liberty and Equality and Human Rights Commission(Interveners) [2013] EWCA Civ 25 (CA). The Court of Appeal has ruled that the Enhanced Criminal Records disclosure provisions of the Police Act 1997 and the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 were not compatible with Art.8 ECHR, as they imposed a blanket statutory regime requiring disclosure of cautions held on the police national computer which was disproportionate and went beyond the legitimate aims of protecting employers and vulnerable individuals. T and B had both had to disclose old and minor cautions that they thought were spent, when applying for jobs working with children and vulnerable adults. W, when aged 16, had been sentenced to five years' detention; disclosure of this conviction meant that she was not able to pursue a career in the Army. The court held, allowing T's and B's appeals but refusing W's application, that the statutory regime requiring the disclosure of all convictions and cautions relating to recordable offences was disproportionate to the legitimate aims of protecting employers and vulnerable individuals in their care, and enabling employers to assess the suitability of a candidate for a particular kind of work. Although disclosable offences did not include those which were so insignificant that they were not recorded on the Police National Computer, that was not a proportionate filtering scheme in the context of Art.8 considerations. The blanket nature of the disclosure regime went beyond what was necessary to achieve its protective purpose and could not be justified by the view that it was a "bright-line" rule which had the merit of simplicity and ease of administration. In W's case, Parliament was entitled to take the view that some offences were so serious that they should never be regarded as "spent". This was not a blanket policy - it discriminated between offences which were very serious and those which were not. Parliament's response to a question of social policy was not disproportionate.

Bevan Brittan Updates
Employment Eye: 2013 Employment law tracker Diets, detox and developments in employment law have been on the agenda for many this January.  It seems unlikely that the government’s ‘one-in two-out’ approach to legislation (effective from this month) will allow any let up this year especially, given the volume of reforms already on the agenda.  So, in 2013, the pace of change will be fast, but Julian Hoskins’ tracker of the key changes chalked up for this year will help keep you up to speed. 

Employment Eye: Losing my religion. The European Court of Human Rights has handed down its long awaited decision in four joined cases on religious discrimination in the workplace.  The Court reached two opposite conclusions on similar facts relating to the right to wear religious symbols at work; and has also looked at balancing competing rights to religious freedom and equality of sexual orientation.  Sarah Michael explains more.

Employment Eye: News round-up. One problem we never have at BB Towers is finding content for our monthly update, and this month is no exception.  The Government has been busy publishing details of a major reforms to the TUPE Regulations; the Public Sector Equality Duty is set to change and new guidance is published; the latest employment tribunal statistics are out; and the Court of Appeal has handed down an important decision on discrimination compensation.  We also have details of our series of client seminars on ‘lessons learned’ from the Mid Staffordshire Public Inquiry by Robert Francis QC, which is due to report on 6 February 2013. 

If you require further information about any of the items raised in this section please contact Julian Hoskins or James Gutteridge.   

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Quality accounts: reporting arrangements for 2012/13. This letter describes amendments to the NHS Quality Accounts Regulations 2010. These amendments come into effect from February 2013 and change the reporting requirements for Quality Accounts being published in June this year.

Spending on health and social care over the next 50 years: why think long term? This report considers the drivers of spending on health and long-term care, and asks whether spending must or should consume such large proportions of GDP in the future, and the fiscal feasibility of this. It examines the evidence that spending will inexorably rise, considers projections and high-level modelling of future health spending both in the United Kingdom and internationally, and debates alternative systems of assessing current and future spending. It also suggests a need for engaged and informed public debate about the choices to be made in future spending on health and social care.

Improving personal budgets for older people. This report reviews the evidence from key pieces of UK research between 2007 and 2012, which focused on the implementation and uptake of personal budgets and direct payments for older people (including those with dementia) in England. It aims to give an overview of the main themes which help to identify the challenges and solutions to improving choice and control for older people through the use of personal budgets and direct payments.

Call for expressions of interest for funding to improve energy efficiency in the NHS. The DH is inviting NHS Trusts and Foundation Trusts to bid for a share of £50m capital funding to invest during 2013-14 for new and innovative projects to improve energy efficiency, reduce carbon emissions and increase resilience to climate change. The closing date for initial EoIs is 28 February 2013.
For details of the proposals together with a summary of our experience of other related energy efficiency and energy generation issues, see our alert: New capital funding for NHS energy efficiency - How you can benefit.

Departmental overview: a summary of the NAO's work on the Department of Health 2011-12. This guide is designed to provide a quick and accessible overview of the Department of Health, and focuses in particular on where performance could be improved, using examples from previously published work. Areas covered include: the department's responsibilities and how it spends its money; financial management; reported performance; and issues identified in NAO reports.

Bevan Brittan Updates
New capital funding for NHS energy efficiency - How you can benefit. On 23 January 2013 the NHS announced the establishment of a new £50m capital fund in the 2013-14 financial year for the improvement of energy efficiency across the NHS in order to contribute towards the NHS Carbon Reduction Strategy for England (CRS).  In this alert we set out some details of the proposals together with a summary of our experience of other related energy efficiency and energy generation issues.

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

Back to topFoundation Trusts 

Mid Staffordshire NHS Foundation Trust – Assessment of Sustainability. The Contingency Planning Team was asked to examine whether Mid Staffordshire NHS Foundation Trust in its current form was able to provide services to local patients in the long term. In this interim report to Monitor, the team reports that the Trust is not clinically sustainable in its present form and cannot break even without compromising future clinical services. The experts are now considering how services should be provided in a way which meets the needs of patients in the Mid Staffordshire area and is also sustainable, including assessing whether some services should be moved to existing or new providers in the area and who these providers might be. It will reflect the views of commissioners from Stafford and Cannock as to which services it is essential to maintain locally. Once Monitor has received recommendations in a final report, the regulator will decide what action to take and whether to put the Trust into Special Administration.

Anticipated merger of Royal Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust and Poole Hospital NHS Foundation Trust – Statement of issues. The Competition Commission has published an issues statement as part of its investigation into the proposed merger of the Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust and Poole Hospital NHS Foundation Trust. The merger is the first between two NHS foundation trusts to be examined by the Commission since the enactment of the Health and Social Care Act 2012, with the Commission's final report due by 24 June 2013.

Monitors monthly Foundation Trust bulletin has been published.

Monitor's Fair Playing Field Review. Statement from Monitor in light of recent media speculation on the Fair Playing Field Review.

Amendments to 'Applying for NHS Foundation Trust status - Guide for Applicants' (January 2013). This document supersedes Amendments to Applying for NHS Foundation Trust status – Guide for Applicants (July 2010).

Monitor introduces improvements to assessment process. For the first time, board members of NHS Trusts seeking foundation trust status will be asked to make a declaration confirming that they have provided all relevant information to Monitor in the course of the assessment process.

Update to 'Your statutory duties: A draft version of the reference guide for NHS foundation trust governors.' This guide was first published by Monitor in October 2009, aimed at governors of NHS foundation trusts. It sets out what we do, how we regulate NHS foundation trusts and how governors can interact with us. This new version has been updated to reflect the new roles and responsibilities of governors as set out in the Health and Social Care Act 2012 (the Act).

Stakeholder engagement on a common definition for person-centred, coordinated (‘integrated’) care. The NHS Commissioning Board, Monitor and key partners have asked National Voices to develop a common and meaningful understanding about integrated care. Deadline for comments and responses to the document is 28 February 2013.

Bevan Brittan Updates
The Mid-Staffordshire NHS Foundation Trust Public Inquiry – Whistleblowing and the impact on workforce culture. Whistleblowing was a key theme that emerged during evidence presented to the Inquiry; and the circumstances and environment in which staff can effectively raise concerns without fear of reprisals or criticism (whether real or imagined) is of central importance not only throughout the NHS, but for all healthcare providers.

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

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Governance statement guidance. The Department of Health has set out the requirements for completion and submission of 2012/13 governance statements for SHAs, PCTs and NHS trusts. The governance statement records the stewardship of organisations to supplement the accounts. It gives a sense of how successfully it has coped with the challenges it faced and of how vulnerable performance is or might be. This statement will draw together position statements and evidence on governance, risk management and control, to provide a more coherent and consistent reporting mechanism.

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

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Information and Data Sharing

Information sharing to tackle violence: audit of progress on delivering the Coalition Commitment 2012. This audit report, produced on behalf of the Department of Health, assesses national progress on information sharing to tackle violence and provides a rating for every local area in the country.

Information overload: Tackling bureaucracy in the NHS. This paper sets out the NHS Confederation's ambitions for tackling the bureaucratic burden of gathering and sharing information to support various types of monitoring, regulation, inspection and accreditation. It welcomes comments and feedback on experiences of bureaucracy in the NHS, and the questions set out in this paper.

Parents at war over child’s medical records – MPS reveals figures on ‘Divorce Day.’ The Medical Protection Society (MPS) reveals the rising number of calls on parents warring over a child’s medical records – a record 179 calls last year – on ‘Divorce Day’ (4 January). The figures work out at one phone call every other day from GPs seeking advice from MPS.

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. Current topics are:-
 Impact of the Health and Social Care Act 2012 on the MHA.
 Gender recognition act and mental health
 Lesbian, gay and bisexual health. 

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.

Eye care information for people with learning disabilities. SeeAbility has launched a new improved online information service dedicated to eye health care for people with learning disabilities. A new dedicated area on the SeeAbility website developed by SeeAbility and Mencap service users aims to improve access to information.

Developing supportive design for people with dementia. This publication marks the completion of 26 Enhancing the Healing Environment (EHE) schemes in 23 NHS acute, community and mental health hospitals in England to improve the environment of care for people with dementia. It seeks to provide practical, value-for-money examples to encourage and inspire staff and their organisations to provide an environment of care that better supports people with dementia.

Advance decisions to refuse treatment: a guide for health and social care professionals. This guide is designed to help health and social care professionals understand and implement the law relating to advance decisions to refuse treatment (ADRT) contained in the Mental Capacity Act (2005). This version replaces that published in September 2008 and covers: how to make an advance decision to refuse treatment; who can make an advance decision; when a decision should be reviewed; and how it can changed or withdrawn.

Psychosis and schizophrenia: recognition and management of psychosis and schizophrenia in children and young people Clinical guidelines, CG155. This clinical guideline offers evidence-based advice on the recognition and management of psychosis and schizophrenia in children and young people under 18.

E-mental health: what's all the fuss about? E-mental health is the use of information and communication technologies (ICT) to support and improve mental health, including the use of online resources, social media and smartphone applications. Greater use of information and technology could help us address resource challenges. E-mental health also has the potential to support cultural transformation and a move towards a social model of health, by empowering service users to exercise greater choice and control and to manage their own conditions more effectively. This paper looks at how the mental health sector might make the most of opportunities offered by e-mental. It gives examples of how service users, mental health providers and other organisations are already embracing e-mental health to bring about change.

Mental health payment by results (PbR) in 2013-14. This letter from David Flory outlines the next steps in the implementation of the PbR approach for adult mental health services. These include mandating the rebasing of current contracts on the basis of the clusters, and mandating the use of some quality and outcome measures. There is also emphasis on the need to improve the quality and completeness of the clinical data that flows to the mental health minimum dataset, and the accuracy of costing the services provided.

Mental Health Act Annual Report 2011/12. In their latest report on mental health services in England, the Care Quality Commission (CQC) has called for urgent reform to improve the care provided for detained and non-detained patients in mental health hospitals and make sure it is based on individual needs.

Suicides in the United Kingdom, 2011. This bulletin presents the latest suicide statistics for the UK, England (including figures for regions) and Wales. New figures are presented for 2011 with a back series of data covering 1981 to 2010 to allow comparison. The potential impact of the use of narrative verdicts by coroners on suicide rates at regional level in England, and in Wales, is also presented. A brief discussion of registration delays in relation to suicide statistics is also included.
 in 2011 there were 6,045 suicides in people aged 15 and over in the UK, an increase of 437 compared with 2010;
 the UK suicide rate increased significantly between 2010 and 2011, from 11.1 to 11.8 deaths per 100,000 population;
 there were 4,552 male suicides in 2011 (a rate of 18.2 suicides per 100,000 population) and 1,493 female suicides (5.6 per 100,000 population);
 the highest suicide rate was seen in males aged 30 to 44 (23.5 deaths per 100,000 population in 2011);
 the suicide rate in males aged 45 to 59 increased significantly between 2007 and 2011 (22.2 deaths per 100,000 population in 2011);
 female suicide rates were highest in 45 to 59-year-olds in 2011 (7.3 deaths per 100,000 population).

eLearning: Adult safeguarding resource. Adult safeguarding is about looking out for the people around us and protecting them from harm. Anyone can find themselves in a difficult situation where there is a possibility that they might be harmed, but when the situation involves someone who needs extra support – known as ‘an adult at risk’ – the situation becomes critical. The resource explores the following questions:
 What is ‘adult safeguarding’ and how does it affect each and every one of us?
 How do I recognise the signs and symptoms of abuse?
 What can I do if I suspect that someone is being harmed?
 What should I do if I believe someone is being harmed but the person asks me to keep the information confidential and take no action?
 What can I do to make it much less likely that a person might be harmed?
 How do I ensure that adult safeguarding is managed correctly in the context of the Mental Capacity Act 2005

Consultation on criteria for approving Approved Mental Health Professional Programmes in England. A Health and Care Professions Council consultation seeks views on draft criteria for approving Approved Mental Health Professional Programmes in England. Comments by April 19, 2013.

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

Back to topObesity 

Delay pregnancy after obesity surgery, women warned. Women who have had weight loss surgery should wait at least a year before trying for a baby, experts have warned.

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

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Primary Care

Proposed imposition of changes to the GP contract in England. The BMA has published a quick guide to the intended changes to GP contracts in England from April 2013 that looks at what the Government's proposals may mean for general practice. It has also issued a survey seeking views from GPs who will have to deal with the implications of these proposed changes on their practice and patients.

Embedding patient and public engagement : a report on learning from interviews with CCG leaders. This report is based on interviews with 18 members of six CCGs which were conducted to research the issues surrounding patient and public engagement and the support CCGs need to embed engagement as part of their practice. It found that CCGs understand the need to engage with patients but questions remain about their ability to translate good intentions into effective plans and to hold their nerve when unpopular decisions need taking.

Personal health budgets: a guide for GPs. The Royal College of General Practitioners has published a practical guide that describes personal health budgets, how they can be used effectively and which patients are eligible. It has been produced with input from GPs and managers with first-hand experience of using personal health budgets at the pilot sites. It includes a useful FAQ section and decision tree for quick reference purposes, plus case studies.

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

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Public Health

Ring fenced public health grants to local authorities 2013-14 and 2014-15. The ring fenced grants for 2013-14 and 2014-15 announced on 10 January 2013 provide local authorities with £2.66bn and £2.79bn to spend on public health services for their local populations.

Public health and alcohol licensing in England. Public health will become the responsibility of local government when it transfers from the NHS to local authorities in April 2013. This LGA briefing for councillors and officers explains the challenges facing councils and the opportunities they have to tackle alcohol-related harm through the licensing process. It aims to place health bodies' new role in alcohol licensing in a strategic context, and to provide guidance to those who will be delivering the responsible authority role.

Making health services adolescent friendly: developing national quality standards for adolescent friendly health services This guidebook sets out the public health rationale for making it easier for adolescents to obtain the health services that they need to protect and improve their health and well-being, including sexual and reproductive health services. It defines ‘adolescent-friendly health services’ from the perspective of quality, and provides step-by-step guidance on developing quality standards for health service provision to adolescents.

Public Health Surveillance – Towards a Public Health Surveillance strategy for England. This document provides an overview of the vision, rationale and plans for delivery of a surveillance strategy for Public Health England, as part of Public Health England's broader information strategy. It also sets out the key benefits and challenges in delivering such a strategy. "Surveillance" is defined as a core public health function that ensures the right information is available at the right time and in the right place to inform public health decisions and actions.

Tackling drugs and alcohol – local government's new public health role. This LGA briefing for councillors and officers explains the challenges facing councils and the opportunities they have to tackle drug and alcohol problems and reduce health inequalities in local communities.

NICE support for local government on walking and cycling and behaviour change. NICE has published two new public health briefings. The first covers how different parts of local government can contribute to encouraging and enabling walking and cycling in local communities, and the second gives guidance on the general principles that should be used when commissioning initiatives to change health behaviours. The briefings are available on the Public health briefings for local government web page.

Stronger together – How health and wellbeing boards can work effectively with local providers. This report from the NHS Confederation sets out a framework of different ways that health and wellbeing boards might approach engagement in their localities. It highlights examples of current mechanisms being used, exploring how these have developed and the advantages of working in these ways.

A toolkit for supporting engagement with local business. The Public Health Responsibility Deal is a large-scale, ground breaking approach to improving public health. The DH is working with the Local Government Association, local authorities, local businesses and other organisations to develop a toolkit to support engagement of local businesses to take simple actions in the areas of alcohol, food, health at work and physical activity. The DH is inviting comments on this draft toolkit; it is also holding a workshop in London on 13 February 2013.

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

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Health Committee - Seventh Report – 2012 accountability hearing with the Care Quality Commission. The Commons’ Health Committee has released its report on the 2012 accountability hearing with the Care Quality Commission (CQC). The CQC is responsible for the registration, review and inspection of health and adult social care services. Since the previous accountability hearing tens of thousands of dental and medical services have been registered and the Chair of the CQC has stepped down. The report considers conclusions to be drawn from registration practices and makes recommendations for the new Chair when they are appointed.

Draft risk assessment framework: consultation document. This draft framework sets out Monitor’s proposed approach to assessing the risk of NHS providers failing financially. It also describes how they will continue to oversee the governance of foundation trusts. The closing date for comments and feedback is 4 April 2013.

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

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Gaining ground: care management programs to reduce hospital admissions and readmissions among chronically ill and vulnerable patients. These three case studies from the USA illustrate the potential of care management programmes in addressing preventable hospital admissions and readmissions by improving care coordination and transitions among high-risk patients. Study sites included two academic medical centres and a managed care organisation owned by a home health agency. The sites employed bundles of interventions involving multidisciplinary teams to improve provider communication, patient and family education, care transitions from the hospital, and follow-up ambulatory care.

Guidance for the Investigation Committee and case examiners to use when they are considering allegations about a doctor’s fitness to practise that relate to encouraging or assisting suicide. This guidance is designed to help decision-makers consider (fairly and consistently) allegations about doctors encouraging or assisting suicide. The guidance may also be helpful to doctors, patients and others as it sets out clearly how the GMC will consider complaints in this area.

When a patient seeks advice or information about assistance to die. This short explanatory guidance has been written in response to the concern expressed by a number of doctors asking how they should respond to patients who asked for advice or help in ending their lives. Doctors were concerned that patients should not feel abandoned by them at this most difficult time – but were concerned that discussions could lead to them breaking the law. It provides advice on how the principles in Good Medical Practice and Treatment and care towards the end of life: good practice in decision making apply when patients who are reaching the end of their life, or who have severe disabilities, seek help or advice about ending their lives.

Good practice in prescribing and managing medicines and devices strengthens and broadens the current advice on prescribing medicines to include medical devices and gives key updates on using unlicensed medicines.

Sir Bruce Keogh to lead review of urgent and emergency services in England. The NHS CB has announced that it is to review the model of urgent and emergency services in England. The review, led by Medical Director Sir Bruce Keogh, will set out proposals for the best way of organising care to meet the needs of patients. The team will work with CCGs to develop a national framework offer to help them ensure high-quality, consistent standards of care across the country.

British HIV Association and Expert Advisory Group on AIDS position statement on the use of antiretroviral therapy to reduce HIV transmission - January 2013. This statement refers to the use of antiretroviral therapy (ART) by HIV-positive individuals to reduce the risk of transmission of HIV.

Best practice for ensuring the efficient supply and distribution of medicines to patients. Guidance for marketing authorisation holders, manufacturers, wholesalers, dispensing doctors, pharmacists and prescribers on managing the medicines supply chain so as to improve the efficiency of supply to patients and reduce the burden caused by supply problems. The guidance has been updated to reflect current law. There are no other changes or new requirements on the NHS.

Trading medicines for human use: shortages and supply chain obligations. This paper sets out the key legal and ethical obligations on manufacturers, wholesalers, NHS Trusts, registered pharmacies and dispensing doctors in relation to the supply and trading of medicines. Recent increases in the export of medicines are a major contributor to supply problems and risk jeopardising patient care. The guidance is relevant to market authorisation holders, manufacturers, pre-wholesalers, full-line wholesalers, short-line wholesalers, brokers, traders dispensing doctors, registered pharmacies and NHS Trusts. The references in the updated guidance have been revised to reflect current law. There are no other changes or new requirements on the NHS.

Mystery shopper report. This mystery shopper investigation found that many NHS patients are hitting an information "brick wall" when it comes to finding out about clinical research. It also reports that 91% of NHS trusts surveyed are not providing information to support patient choice. A commitment to the promotion and conduct of clinical research is included in the NHS Constitution and this report highlights the need for improvement in this area.

A review of the potential benefits from the better use of information and technology in health and social care. This study, commissioned by the Department of Health from PricewaterhouseCoopers, found that measures such as text messages for communicating negative test results, electronic prescribing and electronic patient records could improve care, allow health professionals to spend more time with patients, and save billions of pounds. It cites examples of good practice from across the UK, and estimates that £4.4bn per year could be reinvested in improving care by making similar use of information and technology.

The future of health and social care timeline. This timeline picks out some of the key trends - from changes in population make-up to advances in technology - that will affect how health and social care is delivered over the next 20 years.

State of maternity services report 2011. This report looks at a number of indicators of the pressures on maternity care and the resources available to cope in each of the four United Kingdom countries. It finds that a significant increase in the number of births and a trend towards older mothers is increasing the pressures on maternity care throughout the UK. It recommends providing more midwife-led units and appropriately integrating maternity support workers as two ways to make better use of the financial resources available.

£120 million investment for research to improve NHS services. Announces funding for an open competition to research ways of improving NHS services. Each research project will involve collaborative partnerships between a university and surrounding NHS organisations and will be overseen by the National Institute of Health Research. The funding period for successful applications will run from January 2014 to December 2018 and there will be a maximum of £2m p.a. per Collaboration for Leadership in Applied Health Research and Care (CLAHRC) over the five-year period. The amount of funding allocated will be determined by the scale, nature and quality of the research activity to be conducted. 

Wards dangerously understaffed, say nurses in Nursing Times survey. More than half of nurses believe their NHS ward or unit is dangerously understaffed, according to a survey. The Nursing Times conducted an online poll of nearly 600 of its readers on issues such as staffing, patient safety and NHS culture. The survey also found three-quarters had witnessed what they considered "poor" care over the past 12 months. The government said it had increased staffing and hundreds of new nurses were still being taken on by the NHS.

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

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