16/04/2014
Bevan Brittan provides high quality, comprehensive advice to the NHS and independent healthcare sector. This Update contains brief details of recent Government publications, legislation, cases and other developments relevant to those involved in health and social care work, both in the NHS and independent sector 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 |
Mental Health |
| Clinical Risk/Health and Safety |
Primary Care |
| Commissioning |
Procurement |
| Employment/HR |
Public Health |
| Finance |
Regulation |
| Foundation Trusts |
General |
| Information sharing |
Publications/Guidance
Managing medicines in care homes. This guideline
considers all aspects of managing medicines in care homes and
recommends that all care home providers have a care home medicines
policy. It considers prescribing, handling and administering
medicines to residents living in care homes and the provision of
care or services relating to medicines in care homes.
Focus on: social care for older people. This
report from the Nuffield Trust's and Health Foundation's
QualityWatch programme examines the scale and scope of cuts to
social services for older people in England from 2009/10 to
2012/13. It reveals that most local authorities are tightly
rationing social care for the over-65s in response to cuts,
resulting in significant drops in the number of people receiving
services like home-delivered meals and day care. The study seeks to
assess the impact of social care cuts on the health and well being
of older people and their carers, but finds that, due to a lack of
available data, it is not possible to quantify this. It warns that
the NHS and Government are 'flying blind' in planning services for
vulnerable older people because there is no comprehensive way to
quantify the impact that social care cuts are having on their
health and wellbeing.
A commitment to care. The Health Minister
Norman Lamb has pledged his and the DH’s full support for the
Social Care Commitment, which is a sector led
initiative that focuses on improving workforce quality, instilling
shared values, and driving the highest standards of professional,
compassionate behaviour across adult social care. He encourages
every employer and every employee working in adult social care to
go online and make the Social Care Commitment.
If you wish to discuss any of the items above or the issue of care more generally please contact Stuart Marchant .
Clinical Risk/Health and Safety
Bevan Brittan Training - If you would like to know about our free lunch time training sessions just ask Claire Bentley. You can attend in our London, Bristol or Birmingham office.
Publications/Guidance
Patient safety alert: improving incident reporting and
learning. NHS England and the Medicines and Healthcare products
Regulatory Agency have jointly issued two patient safety alerts to
help healthcare providers increase incident reporting for
medication errors and medical devices. The alerts instruct
providers to take specific steps that will improve data report
quality; and will see the establishment of national networks to
maximise learning and provide guidance on minimising harm relating
to these two incident types.
Managing medicines in care homes. This guideline considers all aspects of managing medicines in care homes and recommends that all care home providers have a care home medicines policy. It considers prescribing, handling and administering medicines to residents living in care homes and the provision of care or services relating to medicines in care homes.
Raising concerns at work: whistleblowing guidance for workers and employers in health and social care. This guidance contains a number of recommendations, aiming to help make whistleblowing an important part of improving the quality of service user support and patient safety.
Consultations
Medical Innovation Bill: Will it encourage responsible
innovation and help prevent what's irresponsible? Seeks views
on whether doctors are being held back from using pioneering
treatments because of the fear of being sued if something goes
wrong. It asks if a proposed Medical Innovation Bill would both encourage
doctors to innovate in medical practice and bolster patient
safeguards. The consultation closes on 25 April 2014.
Introducing the statutory duty of candour. The DH is seeking views on proposals for a duty of candour that will require all health and adult social care providers registered with CQC to be open with people when things go wrong. The draft Health and Social Care Act 2008 (Duty of Candour) Regulations 2014 would impose a specific and detailed duty of candour on all providers where any harm to a service user from their care or treatment is above a certain harm threshold. It will mean providers must notify the patient about incidents where ‘significant harm’ has occurred and provide an apology. This will be a legal requirement and CQC will be able to take enforcement action when it finds breaches. The proposals are open for consultation until 25 April 2014.
News
Survey suggests hospital experiences improving.
The results of the CQC's national survey of hospital patients
suggest that people are generally having a better experience in
hospital compared to a year ago. However, the findings also show
there’s room for improvement, with some variation in the quality of
people’s stay.
Halving avoidable harm and saving up to 6,000 lives. A new ambition to reduce avoidable harm in the NHS by half over the next three years, cut costs and save up to 6,000 lives has been outlined by the Health Secretary Jeremy Hunt. Each NHS organisation will be invited to ‘Sign up to Safety’ and set out publicly their ambitious plans for reducing avoidable harm, such as medication errors, blood clots and bed sores over the next three years. The NHS Litigation Authority, which indemnifies trusts against law suits, has agreed to review the plans and, when approved, reduce the premiums paid by all hospitals successfully implementing them. Every year the NHS spends as much as £1.3bn on litigation claims.
Events
Predict
to Prevent Health Seminar. 30 April 2014 : 09:10 - 16:30
(registration opes at 08:45). Location: Bevan Brittan LLP, Kings Orchard, 1 Queen Street,
Bristol Bs2 0HQ. Over 90% of premature babies now survive the
immediate postpartum period, but the resultant morbidity can be
significant and takes a high toll on families. This exciting new
one day course will be of interest to all clinical staff with an
interest in the prediction and prevention of preterm labour
together with the management of small babies using the best
evidence (where available) in order to guide clinicians in relation
to diagnosis, investigation and management.
Bevan Brittan Articles
The Francis Effect - Duty of Candour and Fit and Proper Person Test
Consultations It is now more than a year since Robert Francis
QC's report into the Mid Staffordshire Inquiry. However, the
recommendations he made to the increase: clarity in healthcare
standards; openness, transparency and candour; and accountability
of senior managers across the health and social care sector are now
crystallising as legislation with increasing pace.
If you wish to discuss any clinical risk or health and safety issues please contact Joanna Lloyd or Stuart Marchant .
Commissioning
Publications/Guidance
Report of the working group into joined up clinical
pathways for obesity. This report recommends greater clarity
around how obesity care in England is commissioned. It aims to
support more equitable access to obesity and weight management
services, including obesity surgery, across the country.
Clinical commissioning groups one year on. The King’s Fund and Nuffield Trust have published a slideshow summarising results of a survey of six CCG areas, which polled the views of GPs about progress of CCGs in their first year. Less than half of the GPs surveyed felt that decisions made by CCGs reflected their views, but the research also suggests that three times as many GPs think they can influence the work of their CCG than could influence their predecessor PCTs.
If you wish to discuss the issue of commissioning please contact David Owens.
Employment/HR
Publications/Guidance
The "snowy white peaks" of the NHS. This study
finds that the black and minority ethnic (BME) population is
largely excluded from senior positions both as NHS managers and as
NHS trust board members. It finds that the pattern extends to all
national NHS bodies, and appears to be particularly serious in
London. It also considers the extent of the gap between the
diversity within the workforce and the local population, and that
visible among trust leaderships and senior management. That gap is
then considered in the light of growing evidence about the impact
of staff and board diversity on the effectiveness of healthcare
provision and the patient experience.
Running on empty: NHS staff stretched to the
limit. This survey of almost 3,000 nurses from across the UK
highlights the pressures staffing levels in the NHS. The survey
reveals that 65% of staff said that they did not have enough time
with patients and 55% reporting that as a result care was left
undone. The report also highlights research that demonstrates the
clear link between appropriate patient staff ratios and patient
mortality.
The implementation of the Working Time Directive,
and its impact on the NHS and health professionals. This report
finds that the implementation of the European Working Time
Directive (EWTD) in the NHS has had an adverse impact on the
training in certain medical specialities, including surgeons and
doctors working in acute medicine. The report was commissioned by
the government in response to concerns it had about the impact of
the directive on patient care and doctors’ learning. The taskforce
found that although some groups of doctors are able to receive the
training they need within the 48-hour week, this is very
challenging for others.
Unnecessary jobs in the NHS. This briefing is the
result of Freedom of Information requests submitted to NHS
organisations regarding non-clinical NHS staff roles.
How to ensure the right people, with the right skills, are in the right place at the right time: a guide to nursing, midwifery and care staffing capacity and capability. This guidance has been jointly issued by NHS England and the Care Quality Commission in order to help deliver on the commitments associated with publishing staffing data regarding nursing, midwifery and care staff levels.
Fair Deal for staff pensions: staff transfers from
Central Government: DH guidance for the NHS Pension Scheme.
Fair Deal is a non-statutory policy setting out how pension issues
are to be dealt with when staff are compulsorily transferred from
the public sector to independent sector providers of public
services. Under the new Fair Deal, these staff will be entitled to
retain membership or eligibility for the public service pension
scheme they were in or eligible to join immediately before the
transfer. This guidance gives information to contracting
authorities, bidders and providers about the application of the new
Fair Deal policy where the relevant public service pension scheme
is the NHS Pension Scheme. It identifies areas that Treasury
guidance had highlighted and outlines the department’s recommended
position for the NHSPS.
See also Procurement Policy Note PPN 05/14: Fair Deal for
staff pensions – Staff transfers from Central Government, which
explains how the policy affects pensions when staff transfer from
Central Government to independent contractors delivering public
services. It states that contracting authorities planning to award
a contract which will involve the compulsory transfer of staff
should make clear to potential bidders as early as possible, and
ideally at the pre-procurement stage of the process, that the new
guidance will apply. It is directly applicable to Central
Government Departments, Executive Agencies, the NHS, maintained
schools (including academies but excluding those covered by other
arrangements for local government) and any other parts of the
public sector under the control of Government ministers where staff
are eligible to be members of a public service pension scheme.
Frontline First: More than just a number. This briefing from the Royal College of Nursing (RCN) on reduction in nursing posts reveals that there are 3,994 fewer full time equivalent (FTE) nursing staff working in senior positions (bands 7 and 8) than in April 2010. Staff working at these bands include ward sisters, community matrons, clinical nurse specialists and advanced nurse practitioners. It warns that the health service has been treating staff with years of experience as ‘disposable’ and a quick way to save money, which means specialist clinical knowledge and leadership is being lost just as it is needed more than ever. Another tactic is ‘downbanding’, or forcing senior staff into lower pay grades. This short-term measure permanently devalues the role and sends a message that experience and leadership is not valued in the NHS. While the RCN recognises that the NHS is experiencing unprecedented financial pressure, it does not believe that financial savings should be made at the expense of these more senior and experienced nursing staff.
Review Body on Doctors' and Dentists' Remuneration
42nd report: 2014. The DDRB provides independent advice on the
pay of doctors and dentists in the NHS. This report sets out the
DDRB analysis of evidence given by relevant organisations and makes
proposals on doctors and dentists’ pay from April 2014.
NHS Pay Review Body (NHSPRB) 28th report: 2014.
This report sets out the NHSPRB analysis of evidence given by
relevant organisations and makes proposals NHS staff paid under
Agenda for Change from April 2014.
Medical revalidation: from compliance to
commitment. This paper, commissioned by the NHS Revalidation
Support Team, presents the findings from focus group discussions
with doctors and interviews with wider staff. It provides analysis
from interviewees’ perspectives and offers commentary on how
leaders at all levels can use revalidation to help create a culture
of excellence in patient care.
Bevan Brittan Articles
Employment news round-up March 2014. Anne
Palmer takes a look at this month's key employment law news
stories, including a raft of changes coming into force next week;
family-friendly and surrogacy developments; zero-hours contracts
and, finally, reports on the dramatic drop-off in employment
tribunal claims and its possible implications.
Pregnancy and maternity discrimination - update and summary guide. Although many cases of maternity discrimination may be fairly clear cut, the picture can be more complex when issues of discrimination arise in relation to maternity related illness, particularly when it occurs after the 'protected period'. Alastair Currie looks a case which clarifies the correct approach to take when an employee is dismissed because of post-natal depression which occurs after maternity leave has ended – and provides a useful summary of this somewhat complex area.
Sharing and caring: your guide to shared parental leave & pay. In what may turn out to be an epoch-making moment in relation to gender equality in the workplace, this October will see new regulations coming into force which will enable parents to choose which of them will take leave to look after their baby during its first year of life. This month, the government has published draft regulations setting out the detail of how they intend the scheme to work in practice. Given that the new arrangements will apply to babies born from next April onwards, it would be sensible to start preparing for the new arrangements now. The operation of shared parental leave is complex but Sarah Maddock provides a useful guide to the new scheme's key features.
If you wish to discuss any employment issues or any of the items raised in this section please contact Julian Hoskins or James Gutteridge.
Finance
Publications/Guidance
Government response to the House of Commons Health
Select Committee report into public expenditure on health and
social care. This paper sets out the Government’s response to
the 18 conclusions and recommendations made in the House of Commons
Health Select Committee report. It agrees with the Committee on the
very real financial challenge facing health and care services, and
recognise that maintaining both financial control and delivering
efficiency savings are of paramount importance to ensuring the
sustainability of the health and care system. It believe that the
reforms it has introduced, the steps it is taking to promote
integration and its commitment to protecting the health budget in
real terms, go some way towards creating this sustainable service.
However, there is more that needs to be done, which is why the
Government is continuing to focus on finance and efficiency through
better procurement, productivity improvements and transformational
changes to services.
Combating inflation - guidanceThis guidance has been produced in order to enable the NHS to take a consistent approach to resisting inflationary pressures as part of a wider programme of initiatives to stabilise non-pay spend.
Solving the NHS care and cash crisis. This report, authored by the former Minister for Health Reform Lord Warner, argues that NHS funding from general taxation should rise only with inflation and proposes a NHS membership scheme for UK residents. It also argues that the creation of a national health and care service is central to tackling the care crisis and integration of health and social care.
Solving the NHS care and cash crisis: Routes to health and care renewal. This report from Reform sets out proposals for a new “National Health and Care Service” (NHCS), based on a new partnership between State and citizen, with integrated health and social care available locally in the community and consolidation of hospital specialist services on fewer sites of higher quality. The authors argue that NHS funding from general taxation should rise only with inflation to avoid starving the rest of the public sector of resources. Higher “sin” taxes on alcohol, tobacco and sugary foods, means-testing of NHS Continuing Care, plus a £10pm NHS membership charge and other patient contributions are needed for the NHS to survive the next five years of austerity. It proposes an NHS Membership scheme for all UK residents, including an annual health MOT to set new responsibilities each year for both the NHS and the individual.
NHS foundation trusts: financial accounting guidance. Guidance for NHS foundation trust finance staff on financial accounting updates, including year-end accounts, the NHS foundation trust consolidation (FTC) process and the agreement of balances process. This version has been updated to include an update on year end information to be provided by Monitor.
Funding transfer from the NHS to social care 2014: directions. The Government has published Directions and an explanatory note about the transfer of £1.1bn in the financial year 2014 to 2015 from the NHS to local authorities for social care. This funding consists of £900m to support adult social care which has a health benefit and an additional £200m for preparing for implementation of mandatory pooled budgets between local authorities and clinical commissioning groups in financial year 2015 to 2016 (the Better Care Fund). The local authority and clinical commissioning groups must agree together how to use the money. They should be read together with the conditions relating to payments between NHS bodies and local authorities.
News
NHS fraud and error 'costing the UK £7bn a year'.
Fraud is costing the NHS £5bn a year, with a further £2bn lost to
financial errors, the former head of its anti-fraud section
says.
If you wish to discuss any of the items in this section or the issue of finance in healthcare please contact David Owens.
Foundation Trusts
Publications/Guidance
NHS Foundation Trust Annual Reporting Manual
2013/14. All NHS foundation trusts must publish annual reports
and accounts to allow scrutiny of the year’s operations and
outcomes. This updated guidance outlines the process foundation
trusts should follow when producing and submitting these documents.
The revisions include changes relating to: the Foundation Trust
Code of Governance; severance payments; off-payroll arrangements;
and Companies Act changes. They also correct some
errors.
NHS foundation trusts: financial accounting guidance. Guidance for NHS foundation trust finance staff on financial accounting updates, including year-end accounts, the NHS foundation trust consolidation (FTC) process and the agreement of balances process. This version has been updated to include an update on year end information to be provided by Monitor.
If you wish to discuss any issues relating to foundation trusts please contact Vincent Buscemi.
Back to topInformation Sharing Publications/Guidance
Good practice – Audit outcomes analysis: Health –
August 2012 to January 2014. This report from the Information
Commissioner’s Office (ICO) gives a snapshot of organisations
providing secondary health care and how they are complying with the
Data Protection Act. The report summarises key findings from 19
audits carried out primarily with NHS Trusts by the ICO. The audits
looked at how personal data is handled by the organisation, and fit
alongside NHS information governance guidelines. The organisations
voluntarily agreed to work with the ICO to identify good practice
and, where necessary, improve procedures relating to the handling
of personal
data.
Good practice: audit outcomes analysis. This report aims to give a snapshot of organisations providing secondary health care and how they are complying with the Data Protection Act. The report summarises key findings from 19 audits carried out primarily with NHS Trusts by the ICO. The audits looked at how personal data is handled by the organisation, and fit alongside NHS information governance guidelines.
If you wish to discuss any issues around information sharing please contact Jane Bennett.
Mental Health
Bevan Brittan Training - If you would like to know about our free lunch time training sessions just ask Claire Bentley. You can attend in our London, Bristol or Birmingham office.
Publications/Guidance
Investing in recovery. This report shows how
money could potentially be saved when proven interventions for
people with schizophrenia and psychosis are made available. It
makes the case for early intervention services which this report
estimates could create savings of £15 for every £1 spent.
Think autism: fulfilling and rewarding lives, the
strategy for adults with autism in England: an update. This
document aims to set out a clear programme that the Department of
Health and other government departments will be taking to improve
the lives of people with autism, primarily through taking actions
that will support local authorities, the NHS, other public services
and their partners with their local implementation work. It has a
new focus on building communities that are more aware of and
accessible to the needs of people with autism.
Note on deprivation of liberty safeguards (DoLS)
judgments of the Supreme Court. This note sets out how health
and social care organisations can continue to act within the law
following the revised test about the meaning of a deprivation of
liberty which has now been supplied by the Supreme Court.
The CQC have published a briefing for providers on
the Deprivation of Liberty Safeguards.
Positive and proactive care: reducing the need for
restrictive interventions. This document provides a framework
for adult health and social care services to develop a culture
where restrictive interventions are only ever used as a last
resort. It identifies actions that will improve people’s quality of
life which should then reduce the need for restrictive
interventions. It sets out ways to know who is responsible for
making these improvements, including effective governance,
transparency and monitoring.
Mental health payment mechanism survey report.
This report presents the results from the 2014 survey of 43 mental
health organisations in relation to the implementation of the
payment mechanism for mental health and adult learning disability
services. The survey sought to find out how the payment mechanism
is currently working in reality; how far the supplementary guidance
has been used for contracting purposes and how the payment
mechanism and guidance might be developed in future years
Think Autism: fulfilling and rewarding lives, the
strategy for adults with autism in England: an update. This is
the Government’s update to the 2010 adult autism strategy
Fulfilling and Rewarding Lives. Think Autism sets out the DH's
programme to improve the lives of people with autism, primarily
through taking actions that will support local authorities, the
NHS, other public services and their partners with their local
implementation work. Think Autism has a new focus on building
communities that are more aware of and accessible to the needs of
people with autism. It also looks at promoting innovative local
ideas, services or projects that can help people in their
communities and how advice and information on services can be
better joined up. There is a package of funding of £4.5m which DH
will be using to take forward themes in the strategy update.
MHN2014: the future of mental health. This
paper discusses what challenges mental health services face and
what these challenges might mean for the future of the nation's
mental health.
Personal Health Budgets: including people with
learning disabilities. This report commissioned by Think Local
Act Personal (TLAP) focuses on personal health budgets for people
with learning disabilities and autism. It shows that when people
and their families get the chance to write their own individual
plan and have control over the money available for their support,
it can lead to better support for individuals who may otherwise end
up in high cost, poor quality residential services. The report
contains examples from around England of NHS CHC teams and people
from specialist learning disability services working together to
better integrate health and care support for individuals. There are
also case studies of people experiencing the benefits of receiving
a personal health budget or joint health and social care
budget.
Mental Capacity Act 2005: post-legislative
scrutiny. This report finds that vulnerable adults are being
failed by the Act designed to protect and empower them. It finds
that social workers, healthcare professionals and others involved
in the care of vulnerable adults are not aware of the Mental
Capacity Act, and are failing to implement it.
Statistics on children admitted to adult mental
health wards released. The report details the recorded number
of under-18s who were inpatients on adult mental health wards in
the year2, number of admissions during the year for people aged
under 18 and the number of days spent by under-18s on such wards
during the year. The report also compares the MHMDS statistics with
the number of notifications made by hospitals to the Care Quality
Commissions of instances where under-18s spend 48 hours or more on
an adult mental health ward.
Supporting recovering in mental health services:
quality and outcomes. Aims to help organisations in the mental
health sector develop clear, empirically-informed statements about
what constitutes high-quality services, and how these will lead to
key recovery outcomes for service users. It also includes a series
of recommendations for health and social care providers and
commissioners, and for NHS England and the Government, that aim to
support development of an evidence-based approach to commissioning
mental health services.
Mental capacity – International aspects.
Solicitors are increasingly finding themselves faced with cases in
which a client who has moved overseas, or owns assets abroad, loses
mental capacity. Often, the solicitor's practice does not routinely
deal with international issues. A new Law Society practice note
gives some initial practical assistance on Lasting Powers of
Attorney for Property and Financial Affairs (LPAs) and Enduring
Powers of Attorney (EPAs), as well as some aspects of
deputyship.
Consultations
Quality Premium: development of additional mental
health indicators. The quality premium rewards CCGs for
improving the quality of services they commission and for
associated improvements in health outcomes and reducing
inequalities. NHS England is seeking suggestions on possible future
mental health measures. These could be directly about mental health
outcomes or could cover wider issues where it is known that people
with mental health needs have poorer outcomes, such as physical
health needs or employment,
Review of the operation of sections 135 and 136 of
the Mental Health Act 1983 in England and Wales. The operation
of ss.35 and 136 of the Mental Health Act 1983, which give the
police powers to temporarily remove people who appear to be
suffering from a mental disorder, and who need urgent care to a
'place of safety' so a mental health assessment can be carried out
and appropriate arrangements made for their care, is being reviewed
by the Government in a new consultation exercise. Responses should
be received by 3 June 2014.
News
The Court of Protection has made it clear that
social workers are among those who can submit evidence of
assessments of people’s mental capacity under the Mental Capacity
Act 2005. The change is reflected in the revised version of the
COP3 form, which states, for the first time,
that the court will accept evidence of social workers.
Mental health teams in police stations and courts scheme
goes live. A trial scheme testing a new model of Liaison and
Diversion (L&D) is launched this week in ten locations across
England. The scheme will fund mental health professionals in police
stations and courts, to ensure people with mental health conditions
and learning disabilities are recognised and get the right
treatment promptly.
Bevan Brittan Articles
Deprivation of liberty – What does the landmark judgment in
Cheshire West mean? The Supreme Court handed down its landmark
judgment in the cases of P v Cheshire West and Chester Council; P &
Q (aka MIG and MEG) v Surrey CC [2014] UKSC 19 on 19 March 2014.
The court found that P, MIG and MEG were all deprived of their
liberty and that in considering the concrete situation of a person
who may be deprived of his liberty attention should focus in
particular on whether the person concerned is under continuous
supervision and control and is free to leave.
If you wish to discuss any of the items raised in the above section
please contact
Simon Lindsay or
Stuart Marchant.
Primary Care
Publications/Guidance
Transforming primary care: safe, proactive,
personalised care for those who need it the most. This guidance
sets out plans for more proactive, personalised and joined up care,
including the Proactive Care Programme, providing the 800,000
patients with the most complex health and care needs with a
personal care and support plan; a named accountable GP; a
professional to coordinate their care; and same-day telephone
consultations. The plan builds on the role of primary care in
keeping patients well and independent. It explains how
professionals across the healthcare system can work together to
transform care to become more proactive and tailored to patients’
individual need.
Primary medical care functions delegated to
clinical commissioning groups: Guidance. NHS England has the
power to direct a CCG to exercise any of its functions relating to
the provision of primary medical care services. This guidance sets
out the arrangements for CCGs to commission out-of-hours primary
medical services for their area.
Prime Minister’s Challenge Fund. NHS England
has announced that 20 GP collaborations have been awarded funds to
run pilots for one year, to transform primary services in their
areas and improve the patient experience, funded by the £50m Prime
Minister’s Challenge Fund.. A wide variety of innovative ideas are
being trialled, including: opening 8am-8pm on weekdays and
weekends; better use of telecare and health apps; more ways for
patients to book appointments including e-mail and Skype; and new
services like care coordinators, to manage care for patients with
complex needs.
Your
health, your way: Your NHS guide to long-term conditions and self
care. NHS Choices guide with advice and practical information
for those living with a long-term condition. It includes a simple
self-assessment tool.
Contract changes 2014/15. NHS Employers, NHS
England and the General Practitioners Committee of the BMA, have
published documents to support GP practices and NHS England area
teams to implement the 2014/15 contract changes. They include the
amended statement of financial entitlement, 2014/15 GMS contract
guidance and audit requirements (including core contractual
requirements and enhanced services) and the 2014 DES and APMS
directions. There is also a letter about implementing the 2014/15 GP
contract.
Dental contract uplift and efficiencies
2014/15. This information sets out the Secretary of State’s
determination on dental contracts and agreements for 2014/15 and
the associated NHS England dental quality and productivity
measures.
GP
practice checklist for QOF 2013/14 year-end. HSCIC has provided
a step-by-step detailed checklist advising GP practices what they
need to do, and when, for the Quality Outcomes Framework (QOF)
2013/14 year-end. The information is split into sections detailing
what actions GP practices should take now, after they are
participating in QOF on CQRS, and after QOF 2013/14 achievement
data are available (from 1 April). Updates will be made to the
checklist on the CQRS website on a weekly
basis.
Improving general practice: A call to action –
Phase 1 report. This report contains a future strategy for
commissioning general practice services. It focuses on the central
role NHS England wants general practice to play in wider systems of
primary care, and it describes NHS England's ambition for greater
collaboration with clinical commissioning groups in the
commissioning of general practice services.
News
GP boundary pilot fails to attract patients.
The BMA reports that a pilot exercise allowing patients to register
with GPs outside of their areas has failed to allay BMA concerns.
Around a quarter of surgeries in the choice of GP practice scheme
did not receive any patient registrations during the 12-month
government pilot. The BMA GPs' committee said the results showed
there was very low patient interest in the scheme and failed to
ease fears that the move could fragment patient care.
If you wish to discuss any queries you may have around primary care please contact David Owens.
Procurement
Publications/Guidance
Procurement transparency. The DH has issued
guidance to all NHS provider organisations on the requirement in
the 2014/15 NHS Standard Contract that ‘the Provider must comply
with Transparency guidance if and when applicable’. It advises on
the actions to be taken to increase openness and clarity about NHS
procurement, covering: opening up public procurement; being
transparent about expenditure; and sharing expenditure data.
NHS standards of procurement: Peer review guidance. Last year the DH published standards for NHS healthcare provider organisations to assess and benchmark procurement performance and identify areas for improvement. There is also an evidence tool that provides suggested evidence that should be reviewed as part of an assessment of a trust against the standards. This peer review guidance provides NHS organisations with an objective review process.
Actions on procurement transparency for NHS provider organisations from April 2014. This document provides guidance to all NHS Foundation and Non-Foundation trusts on the actions to be taken to increase openness and clarity about NHS procurement. Although this document is not applicable to independent sector providers of NHS healthcare, such providers may wish to consider the benefits of adopting the guidance in this document.
If you wish to discuss any queries you may have around procurement please contact Matthew Mo.
Public Health
Publications/Guidance
Annual Report of the Chief Medical Officer:
Surveillance Volume, 2012: On the state of the public’s health.
In her latest annual report, the Chief Medical Officer, Prof Dame
Sally Davies, looks at some of the big issues she identified in her
last surveillance report. She has invited experts to examine these
issues in detail and explore them further. As well as presenting
data and evidence, the CMO also comments on overarching trends.
This year, she highlights concerns that being overweight is
becoming normal as the majority of the adult population is
overweight or obese. Her concern is based on data showing that,
taking into account average height and weight, the average man and
woman in England is overweight. This brings with it an increased
risk of diabetes, strokes and other health problems. The report
highlights studies that show some people who are overweight believe
they are ‘about the right weight’. Other key areas of concern are:
deafness and blindness and dementia; alcohol; and walking and
cycling.
School nursing: Public health services. The DH
has published guidance to support effective commissioning of school
nursing services to provide public health for school aged children.
It also explains how local school nursing services can be used and
improved to meet local needs.
Smokefree and smiling: Helping patients to quit
tobacco. Updated guidance from PHE for dental teams,
commissioners and educators on how they can contribute to reducing
rates of tobacco use. It highlights resources available to support
them. The guidance explains how dentists can offer very brief
advice, using a ‘30 second approach’, to tobacco users and signpost
them to local stop smoking services, by following three simple
steps - Ask, Advise, Act.
Contraceptive services with a focus on young people
up to the age of 25. This guidance recommends that doctors,
nurses and pharmacists provide information about the full range of
contraceptives available, including emergency contraception and
long-acting reversible contraception, and the benefits and side
effects for young people up to the age of 25. It also states that
all young people in England should be given access to contraception
and advice at convenient locations so no-one is denied services
because of where they live.
Local authorities' public health responsibilities
(England) – Commons Library Standard Note. A House of Commons
Library Standard Note sets out the main statutory duties for public
health that were conferred on local authorities by the Health and
Social Care Act 2012. The note includes information on public
health funding, how local authorities have been spending their
ring-fenced public health grants, and accountability
arrangements.
News
Raiding the public health budget. The BMJ claims that
an investigation reveals that local authorities across England are
diverting ringfenced funds for public health to wider council
services to plug gaps caused by government budget cuts, and that
public health staffing in some parts of the country is being scaled
back to save money. But the BBC
reports that the LGA has said that the report was
"scaremongering".
New system leaders share progress and learning
ahead of one-year anniversary. The NHS Confederation has
published practical new resources distilling lessons learned during
Health and Wellbeing Boards’ first full year of operation. The
slide packs and videos share valuable learning and insight from
HWBs across England on their development as system leaders, and
explore three key themes: facilitating shared ownership; working
across boundaries; and the future of system leadership. The videos
also capture HWB members’ reflections on progress made in
developing shared leadership within their board, working with other
HWBs, and what boards could consider doing next as they
develop.
If you wish to discuss any queries you may have around public health please contact Olwen Dutton.
Regulation
Publications/Guidance
Regulation of health and social care professionals
- Summary of responses. The need for a new legal framework
introducing a clear and consistent way of enabling regulators to
uphold their duty to protect the public has been recommended by the
Law Commission in its new draft Bill for the Regulation of Health
and Social Care Professionals. The draft Bill also seeks to reform
the role of the government in professional development, and
recommends the government is given default powers to intervene in
cases of regulatory failure.
Regulation of health care professionals and regulation of social care professionals in England. This project is a review of UK law relating to the regulation of health care professionals, and in England only, the regulation of social workers.
Provision for fees. This document outlines the registration fees that health and social care services will be charged by CQC from 1st April 2014. As the regulation of services is undergoing changes this year, there will only be minimal changes to fees this year.
2013 accountability hearing with the General Medical Council: Tenth Report of Session 2013-14: Report, together with formal minutes relating to the report. A Health Committee report on the General Medical Council (GMC) concludes that the GMC must: seek to better understand what has driven the rise in complaints that it has received and the detail behind them; and formally assess whether revalidation for all licensed doctors is making a significant contribution to the improved practice of doctors.
2013 accountability hearing with Monitor. The model of care provided by the NHS is not changing quickly enough, leading to pressures which threaten the financial stability of individual providers and the quality of care provided, says a report of the Commons Health Committee's annual inquiry into the work of NHS regulator Monitor. The report concludes that, under the current funding regime, the NHS will only be able to deliver the care required from it by significant innovation in the provision of health care, but insufficient change has yet been made
Evaluating the Care Quality Commission’s acute hospital regulatory model: emerging findings. The CQC commissioned The King's Fund and Manchester Business School to explore whether the new approach to inspections provides a better analysis of the performance of an acute hospital. The full report is due to be published in May 2014.
Framework agreement between the Department of Health and the Care Quality Commission (CQC). This document defines the key elements of the relationship between the Department of Health and CQC. It outlines the roles and responsibilities; lines of accountability; and governance arrangements.
Review of the regulation and governance of NHS charities: Government response to consultation. Summarises the responses received to the November 2012 consultation on proposals to revise the governance of NHS charities. As the majority of respondents supported the principle of the proposals for the transition of NHS charities to independent Charity status, the DH believes that it is appropriate to allow those who wish to follow this course to proceed subject to the appropriate safeguards and process being followed. Among other things this will mean they can, if they choose, appoint a dedicated board of trustees with the expertise to develop the charity. At the same time DH will assure that those organisations that wish to retain the status of an NHS Charity may do so. A layer of central bureaucracy is also being removed because in future where NHS charities decide to follow this path neither the DH nor ministers will be involved in appointments to the charities and fund transfers.
Risk assessment framework for independent sector providers of NHS services. This document describes how Monitor carry out their role to ensure the continued delivery of essential healthcare services at independent providers of commissioner requested services.
Consultations
Introducing the statutory duty of candour. The
DH is seeking views on proposals for a duty of candour that will
require all health and adult social care providers registered with
CQC to be open with people when things go wrong. The draft Health
and Social Care Act 2008 (Duty of Candour) Regulations 2014 would
impose a specific and detailed duty of candour on all providers
where any harm to a service user from their care or treatment is
above a certain harm threshold. It will mean providers must notify
the patient about incidents where ‘significant harm’ has occurred
and provide an apology. This will be a legal requirement and CQC
will be able to take enforcement action when it finds breaches. The
proposals are open for consultation until 25 April 2014.
Strengthening corporate accountability in health
and social care: Consultation on the fit and proper person
regulations. Seeks views on proposals to introduce a new
registration requirement that all directors of providers registered
with the CQC must meet a new fit and proper person test. The CQC
will be able to insist on the removal of directors that fail this
test. It follows a previous consultation on proposals to hold
providers to account where there are serious failures in care. The
consultation closes on 25 April 2014.
How the CQC inspect, rate and regulate health and social care services - a consultation. The CQC are asking people who use and run health and adult social care services as well as the public to gather opinion on their plans for regulating, inspecting and rating care services. The consultation will be open until 4th June 2014.
Bevan Brittan Articles
Competition Law - new rules for mergers. The NHS has been
trying to get to grips with a new set of regulators and rules in
particular in connection with mergers of NHS organisations and the
way in which the rules can apply not merely to full mergers but
also to transfers of individual services.
Competition Law news round-up A brief overview of competition law news, brought to you by Laura Brealey and Robyn Sandilands. Here we cover the OFT's final decision in its investigation into the supply of healthcare products and the final report by the CMA on the Private Healthcare Market.
Recent activity of Monitor's Cooperation and Competition Directorate. Monitor's Cooperation and Competition Directorate has now been up and running for a year having taken over from the NHS Cooperation and Competition Panel in April 2013. We take a look back at some of the Directorate's activity over the past year.
If you wish to discuss any queries you may have around regulation please contact Stuart Marchant.
General
Publications/Guidance
NHS 2014 to 2015 Choice framework. This
framework brings together information about patients’ rights to
choice about their health care, where to get more information to
help make a choice, and how they can complain if they have not been
offered choice. The 2014 to 2015 version reflects changes to
expansions of patients’ rights to choice in the areas of: general
practice; mental health; and personal health budgets. The NHS
Choice Framework will be updated annually, as choice rights expand
to new services and patient groups.
How is the NHS performing? This is the eleventh
in a series of quarterly monitoring reports which aims to provide a
regular update on how the NHS is coping as it grapples with the
evolving reform agenda and the more significant challenge of making
radical improvements in productivity. It highlights that the NHS
has had no real rise in spending between 2010/11 and 2013/14, yet
despite this, in broad terms the NHS has continued to provide
services to a growing population and to maintain the quality of
those services. However, our survey finds that there is deepening
pessimism about the ability of the NHS to make ends meet
financially, particularly in 2015/16.
Helping health and care services manage difficult
patient behaviour. This document provides guidance for adult
health and social care staff to develop a culture where restrictive
interventions are only ever used as a last resort.
Survey suggests hospital experiences improving.
The results of the national survey of hospital patients, published
by the CQC, suggest that people are generally having a better
experience in hospital compared to a year ago.
An alternative guide to the urgent and emergency
care system in England. A&E is often seen as a service in
crisis and is the focus of much media and political interest. But
A&E is just the tip of the iceberg – the whole urgent and
emergency care system is complex, and surrounded by myth and
confusion. This animation gives a whistle-stop tour of how the
system fits together and busts some myths about what’s really going
on – explaining that the underlying causes go much deeper than just
A&E and demand a joined-up response across all services.
NHS and social care: public perceptions 2013.
The Department of Health commissions a ‘tracker’ survey to explore
public attitudes towards, and perceptions of, the NHS and social
care services. These reports present the findings from the spring
and winter 2013 surveys. The spring 2013 wave brought in new
questions on whether people are treated with compassion when they
use NHS and social care services and whether it is easy to give
feedback on NHS services.
A call to action: transformative ideas for the
future NHS. Monitor, NHS England and the Trust Development
Authority have published this document in a bid to encourage debate
about the about how the NHS can change its models of care to
provide better services in the future. It states that the NHS needs
to change and it needs to do it now if we are to meet the quality
and efficiency challenges it faces. This report outlines just the
sort of potentially transformative options that local health
economies may wish to consider.
NHS TDA and DH framework agreement. The
Department of Health and the NHS Trust Development Authority have
jointly signed a framework agreement that sets out the relationship
between the two organisations. The agreement covers roles and
responsibilities and lines of accountability, and describes how the
DH and the Authority will work together:
Telehealth and telecare. The UK’s elderly
population is growing and with it the number of people with
long-term health problems. This is putting pressure on the health
and social care systems. Increased use of technology such as
telehealth and telecare may help to improve quality of care and
reduce costs. This note describes current UK telehealth and
telecare initiatives and the role they may play in delivering
future care.
News
Cutting-edge drugs to be fast-tracked to
patients. Severely ill patients with life-threatening and
seriously debilitating conditions will be offered the chance to try
ground-breaking new medicines years before they would previously
have reached them according to an announcement made by the DH. The
Early Access Medicines scheme will allow doctors to make innovative
and promising drugs available to patients as soon as the Medicines
and Healthcare Products Regulatory Agency has said the benefits
outweigh the risks following an initial scientific assessment.
If you wish to discuss any of the items raised in this section please contact Claire Bentley.
