Health and Social Care Update - January 2015

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.

27/01/2015

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 Information Sharing
 Children Mental Health
 Clinical Risk/Health and Safety Primary Care
Commissioning Providers
Emergency Care Public Health
Employment/HR Regulation
Finance General
Foundation Trusts

Care

Publications/Guidance
Care and support – What's changing? Information on what the changes to care and support under the Care Act 2014 will mean for carers and the cared for.

Inclusive integration: How whole person care can work for adults with disabilities. This report focuses on the needs of working-age disabled adults and particularly on how, as health and social care services are increasing integrated, they can be protected and more effectively met.

Response to the consultation on funding formulae for implementation of the Care Act in 2015/16 – Allocations for early assessments against the cap on care costs, universal deferred payment agreements, social care in prisons and additional funding for Care Act implementation, including carers' rights. This response to the July 2014 consultation sets out local authority funding in the financial year 2015 to 2016 for: early assessments for against the cap on care costs (£146m); universal deferred payment agreements (£83.5m); carers and Care Act implementation (£55.5m); and social care in prisons (£11.2m). The funding for the first three grants will be paid to local authorities as a DCLG revenue grant, and the funding for social care in prisons will be paid as a DH revenue grant.

If you wish to discuss any of the items above or the issue of care more generally please contact Stuart Marchant.

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Children

Publications/Guidance
Working together to safeguard children: revisions. The DfE invites views on changes to the statutory guidance Working Together to Safeguard Children. The revisions include 3 major changes and some small updates and clarifications. The three proposed changes are: 
 the referral of allegations against those who work with children; 
 notifiable incidents involving the care of a child; and
 the definition of serious harm for the purposes of serious case reviews.

If you wish to discuss any of the items above or the issue of care more generally please contact Claire Bentley

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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
Complaints and raising concerns. This House of Commons Health Select Committee report concludes that, while patient safety and the treatment of complaints and concerns have become high profile issues in the last few years, this is only the beginning of a process of change with significant scope for further improvement.

Quality first: managing workload to deliver safe patient care. This guidance aims to help GPs ease their workload pressures and find more time for direct patient care. It provides practical steps practices can take to address rising workloads.

Safe staffing for nursing in A&E departments. NICE has outlined draft guidance to help A&E departments ensure there are enough nursing staff available to provide safe care at all times to patients.

A qualitative study of decision-making and safety in ambulance service transitions Decisions made by front-line ambulance staff are often time critical and based on limited information, but wrong decisions in this context could have serious consequences for patients. There has been little research carried out in the ambulance service setting to identify areas of risk associated with decisions about patient care. The aim of this study was to qualitatively examine potential system-wide influences on decision-making in the ambulance service setting and to identify useful areas for future research and intervention.

Patient choice and the effects of hospital market structure on mortality for AMI, hip fracture and stroke patients. This report is the result of a study which examines the effect of market structure on mortality rates for acute myocardial infarction, hip fracture and stroke in 2002/3 and 2010/11 and whether the introduction of patient choice policy in 2006 had an effect.

Consultations
The Government Response to Part 2 of the Consultation on Reform of Court Fees and Further Proposals for Consultation. This publication sets out the Government’s response to Part 2 of the consultation paper, Court fees: proposals for reform, which sought views on proposals for charging enhanced fees for certain proceedings in the civil courts in England and Wales. In Part 1 of this response, we set out those measures we intend to implement following the consultation. In Part 2, we seek views on further proposals to raise fee income from court proceedings. The deadline for providing responses to the further consultation is 27 February 2015. See Hailsham Chambers summary of the consultation response and what will happen now. See also Guardian article.

Cosmetic Surgery Interspecialty Committee. Patients paying for cosmetic surgery privately should have access to clear, unbiased and credible information about their surgeon, care provider, procedure and likely outcomes. This was according to proposals put out for consultation by the Royal College of Surgeons (RCS) and formed part of their intentions to improve standards of care for cosmetic surgery. The consultation will run until 20 March 2015.

If you wish to discuss any clinical risk or health and safety issues please contact Joanna Lloyd or Stuart Marchant.

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Commissioning

Publications/Guidance
Dispute Resolution Alert: New NHS dispute resolution process for 2015/16 contract negotiations. A Centre for Effective Dispute Resolution publication provides advice for contract negotiators on a new NHS dispute resolution regime for 2015/16. The guidance considers the definition of mediation, and discusses negotiation training.

Commissioning better community services for NHS patients. This report looks at what CCGs are doing about community services as the contracts entered into after the Transforming Community Services programme expire. As contracts expire, commissioners need to consider what options are best for patients. This review of community services commissioning explaining how commissioners can support a move to more co-ordinated care for patients closer to home.

A rapid synthesis of the evidence on interventions supporting self-management for people with long-term conditions: PRISMS - Practical systematic Review of Self-Management Support for long-term conditions. The National Institute of Healthcare Research has undertaken a rapid, systematic overview of the evidence on self-management support for long term conditions (LTCs) to inform health-care commissioners and providers about what works, for whom, and in what contexts.

Funding healthcare – Making allocations to local areas. This report from the HC Public Accounts Committee concludes that the slow progress towards target funding allocations means the Government has not fulfilled its policy objective of equal access for equal need. It finds that around two-fifths of CCGs and three-quarters of local authorities are receiving more than 5% above or below their target funding allocation. The National Audit Office has calculated that, if the slow pace of change were to continue, it would take around 80 years for all local commissioners to get close to their target funding allocations; for local authorities and the expenditure on public health, it would take 10 years before no local authority remained below its target allocation by more than 5%. The Committee's recommendations include that the DH should develop an evidence base to inform government decisions on how quickly public health allocations to local authorities should move towards their target allocations.

Business case process for CCGs proposing to in-house commissioning support services from a CSU. NHS England has revised the process for CCGs to follow when proposing to provide their own commissioning support. The strengthened business case process is designed to facilitate collaborative working, support continuity of key support services, minimise stranded costs, ensure fair treatment of NHS staff, and deliver value for money.

Managing conflicts of interest: Statutory guidance for CCGs. NHS England has issued statutory guidance on conflicts of interest, which includes specific provisions for co-commissioning of primary care services. Although it is particularly relevant for CCGs considering governance arrangements for co-commissioning, CCGs should note that it supersedes previous guidance on managing conflicts of interests across the range of CCG responsibilities. The guidance is issued under s.14O and s.14Z8 of the NHS Act 2006 and CCGs must have regard to it, with the onus on them to explain any non-adherence. It states that when a CCG is seeking to take on delegated or joint commissioning responsibilities, their audit committee chair and accountable officer will be required to provide direct formal attestation to NHS England that the CCG has complied with this guidance. Subsequently, this attestation will form part of an annual certification. CCG approaches to management of conflicts of interest will also be considered on an ongoing basis as part of CCG assurance. Further details will be issued early in 2015 as to the forms that the initial attestation, the annual certification and ongoing assurance will take.

Making the health sector work for patients. An opportunity to improve community services for patients could be missed through plans to automatically renew community services contracts, claims a report by NHS regulator Monitor. The report looks at how clinical commissioning groups (CCGs) can find the best ways to support a move to more co-ordinated care for patients closer to home as the contracts expire.

If you wish to discuss the issue of commissioning please contact David Owens.

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Emergency Care

Publications/Guidance
Professional guidance on the structure and content of ambulance records. NHS England has published new guidance describing the clinical professional standards for the structure and content of ambulance patient records. The guidance was produced by the Royal College of Physicians’ health informatics unit. The implementation of this guidance will allow information to be shared across settings to support patient care and be used in performance management, audit and commissioning, providing benefits for patients, the ambulance services, and the services with which they work.

Explaining variation in emergency admissions: a mixed-methods study of emergency and urgent care systems. The National Institute of Healthcare Research has published a study on variation in avoidable emergency admissions between different emergency and urgent care systems in England. It concludes that deprivation explained most of the variation in avoidable admission rates.

An alternative guide to the urgent and emergency care system in England. The King's Fund has produced an animation that gives a whistle-stop tour of how the whole urgent and emergency care 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.

Safe staffing for nursing in A&E departments. NICE has outlined draft guidance to help A&E departments ensure there are enough nursing staff available to provide safe care at all times to patients.

A qualitative study of decision-making and safety in ambulance service transitions Decisions made by front-line ambulance staff are often time critical and based on limited information, but wrong decisions in this context could have serious consequences for patients. There has been little research carried out in the ambulance service setting to identify areas of risk associated with decisions about patient care. The aim of this study was to qualitatively examine potential system-wide influences on decision-making in the ambulance service setting and to identify useful areas for future research and intervention.

News
Possible changes for ambulance services outlined. There could be a change in the way ambulance services respond to 999 calls, if two pilot NHS schemes are successful. The schemes will increase the amount of assessment time given to call handlers amid fears that too many ambulances are being dispatched unnecessarily. The move follows recommendations sent to the Department of Health from NHS England.

If you wish to discuss the issue of emergency care please contact Claire Bentley.

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Employment/HR

Publications and Guidance
Securing the future workforce supply: obstetrics and gynaecology stocktake. This report is the result of a review, commissioned by the Department of Health, into the obstetrics and gynaecology (O&G) workforce in England. It estimates that the future level of workforce supply that would be needed to maintain current levels of O&G service on a per-patient basis. It also considers the number of higher specialty training numbers required to ensure supply is broadly in balance with expected patient demand by the end of the projection period. Additionally, it also provides an estimate about the O&G workforce that would be required to deliver a robust consultant-led seven-day service.

Revoking education standards with maximum time limits - consultation. Currently, student nurses and midwives are required to finish full-time programmes within five years and part-time programmes within seven years in order to be eligible for registration. The NMC proposes to remove these maximum time limits from NMC standards, while ensuring full responsibility for the management of education programmes lies with approved education institutions. Post-registration programmes, which are currently given time limits either by the NMC or by the specific education institution, will also be affected by the proposed changes. The consultation closes on 12 March 2015.

Bevan Brittan Updates
Stress test: disciplinary action and stress The Court of Appeal has summarised and clarified the correct approach to a psychological injury (namely, a depressive illness) caused by unfairly conducted suspension and disciplinary process. As Julian Hoskins explains, the Court of Appeal has built on the developing body of case law on stress at work claims and confirmed that, usually, damages for such claims will not be available where the employer believed that the employee in question was mentally robust and could withstand a serious set-back at work.

If you wish to discuss any employment issues please contact Julian Hoskins or James Gutteridge.

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Finance

Publications/Guidance
Quarterly monitoring report: issue 14. The quarterly monitoring report examines the views of finance directors on the productivity challenge they face, as well as some key NHS performance data to see how the NHS is performing. This latest issue warns that problems in hospitals are spreading beyond A&E to other key areas of performance, increasing the risk of a NHS crisis.

Funding healthcare – Making allocations to local areas. This report from the HC Public Accounts Committee concludes that the slow progress towards target funding allocations means the Government has not fulfilled its policy objective of equal access for equal need. It finds that around two-fifths of CCGs and three-quarters of local authorities are receiving more than 5% above or below their target funding allocation. The National Audit Office has calculated that, if the slow pace of change were to continue, it would take around 80 years for all local commissioners to get close to their target funding allocations; for local authorities and the expenditure on public health, it would take 10 years before no local authority remained below its target allocation by more than 5%. The Committee's recommendations include that the DH should develop an evidence base to inform government decisions on how quickly public health allocations to local authorities should move towards their target allocations. 

If you wish to discuss any of the items in this section or any issues around finance please contact David Owens.

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Foundation Trusts

Publications/Guidance
Audit code for NHS foundation trusts. Monitor has issued an updated Audit Code for FTs that corrects outdated referencing in the document, improves the consistency in audit reporting between firms, and reflects the adoption of enhanced audit reporting to accompany amendments made in the NHS foundation trust annual reporting manual for 2014/15.  

If you wish to discuss any issues relating to foundation trusts please contact Vincent Buscemi.

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Information Sharing Publications/Guidance
The first year: the Independent Information Governance Oversight Panel’s report to the Secretary of State for Health. This report looks at whether health and social care organisations are sharing information wisely and preventing improper disclosure of personal data. It shows evidence of pockets of exemplary practice but the overall picture is of a need for improvement. It concludes that a basic condition for building public trust is a commitment to more transparency about how data is collected, stored and used. It argues that individuals must also be able to opt out of data sharing arrangements and be confident that their wishes are being respected consistently across the system.
 

Information: to share or not to share This is the first annual report of the Independent Information Governance Oversight Panel, chaired by Dame Fiona Caldicott and set up by the Secretary of State for Health in November 2013. It looks at whether health and social care organisations are sharing information wisely and preventing improper disclosure of personal data. It shows evidence of pockets of exemplary practice but the overall picture is of a need for improvement. It concludes that a basic condition for building public trust is a commitment to more transparency about how data is collected, stored and used.

If you wish to discuss any issues around information sharing please contact Jane Bennett.

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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
New Mental Health Act code of practice. The main changes to the code include:
• 5 new guiding principles
• new chapters on care planning, human rights, equality and health inequalities
• consideration of when to use the Mental Health Act and when to use the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards and information to support victims
• new sections on physical health care, blanket restrictions, duties to support patients with dementia and immigration detainees
• significantly updated chapters on the appropriate use of restrictive interventions, particularly seclusion and long-term segregation, police powers and places of safety
• further guidance on how to support children and young people, those with a learning disability or autism. The new code will come into force on 1 April 2015, subject to Parliamentary approval.

Report on the deprivation of liberty safeguards published by Care Quality Commission. The Care Quality Commission has published its fifth annual monitoring report on the implementation of the deprivation of liberty safeguards (DoLS). These are part of the Mental Capacity Act, and they protect the rights of adults in care homes and hospitals who lack mental capacity, in situations where they need to be deprived of their liberty to be given necessary care or treatment.

Representation before mental health tribunals—Updated January 2015. Any legal representation provided to people detained on the grounds of mental disorder must be 'effective', updated Law Society guidance makes clear. It includes detailed information on communicating with, receiving instruction from and representing adults and children before mental health tribunals. The guidance is relevant to all lawyers who represent clients before the First-tier Tribunal (Mental Health) in England and the Mental Health Review Tribunal for Wales.

Model specification for child and adolescent mental health services: targeted and specialist levels (tiers 2/3) This resource includes tools for commissioning effective mental health services for children and young people. The model specification template has also been made available for commissioners to use when developing their own specification for their local area.

The ADASS DoLS project group have been working on new DoLS forms which are now available to download here. These are the forms emailed by the DoLS Forms Project Group on 11/1/15 (without restricted editing and with an amended eligibility section in Form 4).

Choice in mental health care. This guidance aims to help commissioners, GPs and providers support mental health patients exercising their legal rights to choose who provides their care and treatment. This guidance has been updated to reflect suggestions from consultation which highlighted the need for further clarity and it also includes a set of clinical scenarios to illustrate how mental health patients’ legal rights should work in practice.

Review of the operation of Sections 135 and 136 of the Mental Health Act. This is a summary of the report and recommendations by the Home Office and the Department of Health in England on their joint work to review the operation of sections 135 and 136 of the England and Wales Mental Health Act 1983. See more here.

Sections 135 and 136 of the Mental Health Act 1983: literature review. This literature review forms part of the government's review of sections 135 and 136 of the Mental Health Act 1983. It covers the wider social and legislative context including human rights, published data-sets and trends, who is detained, where they are held, and for how long, issues over diversity and equality, and the experiences of patients and practitioners including relationships between police and health services.

Parity of Esteem for Mental Health - POST Note. A Houses of Parliament Parliamentary Office of Science and Technology (POST) Note outlines the history of efforts to achieve parity of esteem between mental and physical health in care standards and public attitudes, the various ways in which parity is defined and measured, the challenges of achieving this ideal and the strategies that may be employed to that end. 

Mental health treatment requirements – Guidance on supporting integrated delivery. The Mental Health Treatment Requirement (MHTR) is one of three possible treatment requirements which may be made part of a Community Order. The MHTR is intended for the sentencing of offenders convicted of an offence(s) which is below the threshold for a custodial sentence and who have a mental health problem which does not require secure in-patient treatment. This guidance from the National Offender Management Service supports service commissioning and provider agencies in enabling MHTR delivery locally. It reflects the changes to responsibility for probation services in England and Wales from 2014 resulting from the Government’s Transforming Rehabilitation reforms and the Offender Rehabilitation Act 2014, and includes information on who to contact for further information.

Integrating personal budgets for people with mental health problems. The Social Care Institute of Excellence has published a guide for staff working with mental health personal budgets. It provides an overview of the terminology and current policy background; it also examines the key areas that need to be tackled for integration to become a reality and makes recommendations for implementing integrated personal budgets in mental health.

Cases
Re CP [2015] EWCOP 1. CP who was 91 years old suffered from dementia. He was taken by the applicant local authority and kept at a locked dementia unit for 17 months. It was held that his detention there had violated his rights under arts 5 and 8 of the European Convention on Human Rights. The Court of Protection considered a consent order and declarations as to CP's capacity. See also Lucy Series comment.

News
Deprivation of liberty safeguards paperwork cut as ‘unnecessary’ forms scrapped Government-commissioned review cuts number of Dols forms from 32 to 13 in bid to speed up process without losing 'necessary quality'

Real-terms funding cut to children’s mental health services revealed Figures released to parliament show NHS funding for CAMHS services fell by more than 6% in real-terms over four years

Eight pilots to lead innovation in children’s mental health.. Announces that pilots in NEW Devon, Derbyshire, Newcastle, Tameside and Glossop, Norfolk, Southampton, Wolverhampton and South Sefton have all been awarded up to £75k to develop their plans for innovating change to services for children and young people with mental health issues.

£12 million to help people with mental health problems get back into work. Announces that four pilot areas will receive a share of £12m funding to test whether better coordination of mental health and employment services could help thousands of people find and stay in employment as well as improve their mental health. The pilot areas are: Blackpool, Greater Manchester, North East Combined Authority and West London Alliance.

Roofing firm in court after teenager breaks back in fall. Preston building firm W Hughes and Son Ltd has been fined £10,000 after a 17-year-old mental health patient fell off the roof of the Royal Preston Hospital in Fullwood. A prosecution was brought by the Health and Safety Executive (HSE) after an investigation found that the company had failed to prevent access to scaffolding on the site.  

Bevan Brittan Events
New Code of Practice: Mental Health Act 1983. 05 March 2015 : 10:00 - 11:00 (registration opens at 09:30) Location: Bevan Brittan LLP, Kings Orchard, 1 Queen Street, Bristol, BS2 0HQ. The Mental Health Act Code of Practice was last revised in 2008. Since then, there have been huge changes in legislation, policy, case law and professional practice. Subject to Parliamentary approval, a new Code of Practice will come into force on 1 April 2015 which aims to reflect and embed developments since 2008. This seminar looks at the changes to the Code.

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

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Primary Care

Publications/Guidance
Managing conflicts of interest: statutory guidance for CCGs. NHS Clinical Commissioners (NHSCC), the Royal College of General Practitioners (RCGP) and the British Medical Association (BMA) have come together to support CCGs to manage conflicts of interest when they take up proposals to commission primary care (General Practice) in 2015.

General Practice in England - Commons Library Standard Note. A House of Commons Library Standard Note provides general background for Members and their staff on NHS primary medical services provided by general practitioners in England.

Quality first: managing workload to deliver safe patient care. This guidance aims to help GPs ease their workload pressures and find more time for direct patient care. It provides practical steps practices can take to address rising workloads. 

Consultations
Inadequate GP practices to be offered help. Any GP practice rated by inspectors as inadequate overall will be automatically placed in special measures, under new proposals announced by the Care Quality Commission (CQC). The practice would also be offered a package of intensive support to help it improve. CQC is seeking views from anyone who wishes to have a say on the proposals and the consultation will be open until 5 February 2015. 

News
CQC inspectors find 60 GP practices to be Good or Outstanding. Following inspections by specialists, the Care Quality Commission (CQC) has published 75 reports on the quality of care provided by GP practices under its new programme of inspections. The reports show that three of the practices have been rated as outstanding, 57 are classified as good, ten require improvement and five have been rated as inadequate. 

If you wish to discuss any queries you may have around primary care please contact David Owens.

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Providers

Consultations
Integrated care licence condition: draft guidance for providers of NHS-funded services This consultation seeks views on draft guidance outlining the core principles NHS providers can follow to enable patients to receive care in an integrated way. It closes on 13 February 2015.

If you wish to discuss any issues relating to providers please contact Vincent Buscemi.

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Public Health

Publications/Guidance
Tackling the causes and effects of obesity This report argues that health problems associated with being overweight or obese cost the country £5 billion per year, with numbers of people with obesity predicted to more than double in the next 40 years. It warns that councils do not have enough money in their public health budgets to properly tackle obesity once mandatory services such as sexual health and drug and alcohol services have been paid for. The report calls for a fifth of existing VAT raised on sweets, crisps, takeaway food and sugary drinks to go to boost council-run grassroots initiatives with a proven track record, such as leisure activities and health awareness campaigns.

A councillors' guide to tackling new psychoactive substances. Growing numbers of councils have been calling for greater powers to tackle the sale of new psychoactive substances (NPS), also known as ‘legal highs'. Faced with the unique problems associated with tackling the sale of NPS, councils across England and Wales have employed a range of options to try and protect their communities from the harms caused by NPS. This guide from the LGA provides councillors with an introduction to NPS, how they can raise awareness of the harm NPS use can cause and what councils can do to tackle sales of NPS in their areas.

Tackling the causes and effects of alcohol misuse. The LGA highlights how the transfer of public health responsibilities from the NHS to local government and Public Health England represents a unique opportunity to set out a local approach to tackling alcohol misuse. The LGA is calling on the Government to help people live healthier lives and tackle the harm caused by excessive drinking and alcohol dependence by: reinvesting a fifth of existing alcohol duty in preventative measures; giving councils the power to take public health issues into account when making licensing decisions; and supporting licensing and trading standards departments to better tackle the black market in alcohol.

NHS public health functions agreement: Variation to the 2014-15 agreement on public health functions to be exercised by NHS England. The NHS public health functions agreement sets out the arrangements under which the Secretary of State delegates responsibility to NHS England for certain public health services (known as Section 7A services). This document substitutes a new Table 4 (Variation No.1) with amended key deliverables for phased implementation of the extension of the seasonal influenza vaccination programme for children.

Female genital mutilation – The case for a national action plan. Sets out the Government's response to the Select Committee’s report, which was published on 3 July 2014. It includes details of the package of domestic measures to tackle FGM in the UK that were announced at the Girls Summit of July 2014, which focus on improving the law enforcement response, supporting frontline professionals and working with communities to prevent abuse.

Public Health England’s grant to local authorities. This report from the NAO examines whether PHE’s arrangements for the £2.7bn ring-fenced grant funding to 152 local authorities are likely to lead to intended outcomes and value for money. It concludes that the new public health agency has made a good start in supporting local authorities with their new responsibilities for public health; however, it is too soon to tell whether the agency’s approach is achieving value for money.

Public health ring-fenced grant conditions 2015 to 2016 – Local authority circular LAC(DH)(2014)2. Sets out the DH's public health grant determination and conditions for 2015 to 2016. These cover 0-5 children's services due to be transferred to local authorities in October 2015. In 2015 to 2016 the allocations increased to £2.80bn as a result of locally agreed baseline adjustments of £ 7.7m submitted to the DH.

If you wish to discuss any queries you may have around public health please contact Olwen Dutton.

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Regulation

Publications/Guidance
Doctors who commit suicide while under GMC fitness to practise investigation. This is the report of an internal review into the way that vulnerable doctors are treated whilst undergoing fitness to practice investigations. It examined the period between 2005 and 2013 and found that 28 doctors undergoing fitness to practise investigations committed suicide or died of a suspected suicide. Whilst significant improvements have been made to the investigations process in recent years, the report makes a number of recommendations for further reducing the impact of investigations on doctors who have health problems.

Monitor's Rules of Procedure. Monitor's rules of procedure have been updated. The guide includes information about: Monitor's structure; the board's responsibilities rules for board and committee meetings; and ethical rules.

Complying with Monitor’s integrated care requirements. This updated guidance reflects newly published documents (e.g. related to pricing) and clarifies and consolidates a number of sections where content relates to the choice and competition rules and regulations. The guidance assists providers and commissioners of healthcare services, and health and wellbeing boards to comply with their integrated care obligations. It also explains the relationship between these obligations and the other rules that Monitor enforces.

Consultations
Summary of the responses to the consultation on the Monitor licensing regime and social care organisations. In June 2014 the DGH consulted on whether NHS continuing healthcare and NHS funded nursing care services should remain exempt from Monitor’s licensing regime. This document sets out the response to that consultation. It states that the DH’s view is that NHS continuing healthcare and NHS funded nursing care services should be exempt. The majority of respondents were in favour of continuing the exemption; however, there was a collective view that the exemption should not extend to nursing care services being designated as a Commissioner Requested Service. The Secretary of State now intends to make National Health Service (Licence Exemptions, etc) Amendment Regulations 2015, which will come into force on 1 April 2015.

News
New regulations introducing a time limit on provisional registration. The GMC announces an important change to the way that doctors can use their provisional registration. From 1 April 2015, the length of time doctors will be allowed to hold provisional registration will be limited to a maximum of three years and 30 days (1125 days in total). After this their provisional registration will expire.

If you wish to discuss any queries you may have around regulation please contact Stuart Marchant.

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General

Publications/Guidance
The Forward View into action: planning for 2015/16. This guidance for the whole NHS system has been produced in collaboration with Public Heath England, Monitor, the NHS Trust Development Authority, the Care Quality Commission and Health Education England. It outlines the action which the NHS will be taking in relation to the recommendations made in the Five Year Forward View. Recommendations include investment in prevention of illness; financial investment in the transformation of primary care, mental health services and local health economies; and the ongoing commitment to providing high-quality data to staff and carers.

Learning for the NHS on procurement and supply chain management: a rapid evidence assessment This study aimed to describe approaches to procurement and supply chain management (SCM) in selected areas and to identify best practices that may inform procurement and SCM in the NHS.

Dalton Review: Practical checklists. Provide a digest of information for providers to consider when thinking through the opportunities outlined in the Dalton Review.

Who's Who in the regions? The regional VCS network organisations have each developed a regional "Who's Who" guide to key people working in health, wellbeing and care in each region. The guides include relevant people from clinical commissioning groups, health and wellbeing boards, CQC, NHS England area teams, commissioning support units and local Healthwatch.

Hospital referral to community pharmacy: An innovators’ toolkit to support the NHS in England. The RPS believes that patients in hospital should be routinely referred to their community pharmacist for post-discharge assistance with medicines. Community pharmacists can support patients to ensure that they get the best from their medicines by providing the new medicine service and post-discharge medicines use reviews, or just update their patient medication records with any changes. Ideally, such referrals should be made electronically. If discharge letters are electronically produced in hospital, community pharmacists should have access to these as part of the referral process. This toolkit is intended to aid decision makers in health economies to make a case for change and support them to implement a referral system. It is aimed at Chief Pharmacists of Trusts and Heads of Medicines Optimisation / Management in CCGs.

Leadership vacancies in the NHS – What can be done about them? The King’s Fund, in collaboration with the HSJ Future of NHS Leadership Inquiry, undertook an FOI request to obtain an accurate picture of board-level vacancies in NHS provider organisations, supplementing the data gathered with in-depth interviews and a literature review. This report details the level of vacancies and their impact and suggests reasons for this.

Mergers in the NHS. The Health Foundation has published a report that looks at lessons from the Competition Commission's decision to block the proposed merger of Poole Hospital NHS FT and the Royal Bournemouth and Christchurch Hospitals NHS FT. It states that this was the first merger between two NHS foundation trusts to be examined by the competition authorities following the Health and Social Care Act 2012 which confirmed their role in assessing the competition aspects of mergers involving foundation trusts. While the case itself is old news, the merger decision process is still often referred to in the NHS as a barrier to needed and major service change. The report authors carried out an independent analysis of the proposed merger. The report aims to draw out some lessons that would be useful for the NHS in the future, especially since major service reconfiguration may well be needed in some areas.

Surveillance Camera Commissioner – Annual report 2013 to 2014. This report outlines the work that the Commissioner has completed and his future plans. It sets out how he continues to ensure that the Surveillance Camera Code of Practice is promoted to relevant authorities under s.33 (5) of the Protection of Freedoms Act so that they fully understand and fulfil their duty under it. He also intends to explore other opportunities to promote the Code to non-relevant authorities, seeking voluntary adoption across a broad range of sectors. He notes that some relevant authorities, particularly public space CCTV managers in local authorities, show enormous enterprise in adopting the principles within the Code. However, the application of the Code is not consistent throughout all relevant authorities, e.g. where some traffic enforcement officers utilise the same cameras as those used to deliver crime and disorder reduction strategies. Accordingly where dual use CCTV Operation Rooms are in use he intends to raise the obligations within the Code to encourage compliance. 

Using surveillance: guidance for service providers. Guidance from the CQC on the use of surveillance. It sets out some of the key issues that providers need to take into account to help ensure decisions about the potential use of surveillance are informed, appropriate and lawful. It describes some of the alternative steps providers can consider before deciding to use surveillance and signposts relevant legislation. 

Compassion in practice: two years on Compassion in Practice, the national strategy for nurses, midwives and care staff, was launched in December 2012. This report talks about the value of the 6Cs (care, compassion, competence, communication, courage and commitment), how they are spreading across health and social care and informing the commissioning process, along with the role care makers play in bringing the vision to life.

Improvement in cancer services in England--NAO report. Progress has been made in Department of Health (DH) and NHS cancer services, according to a report from the National Audit Office (NAO). Overall outcomes for cancer patients have continued to improve since the NAO last reported on cancer services in 2010, although significant variations in outcomes and access to services across different areas of England show there is scope for further improvement.

Consultations
Release of a body from hospital: good practice form. Seeks views on a good practice form to help hospitals put in place a process for releasing bodies to funeral directors or the bereaved. Concerns have been raised that a number of hospitals are requiring sight of the registrar’s Certificate for Burial and Cremation (the Green Form) prior to agreeing release of a body, despite there being no legal requirement for this. Having this requirement can lead to delays with funeral arrangements and can cause unnecessary distress to the bereaved. The DH has developed a good practice form to support a more consistent, quality-controlled, and timely body release process. This form will provide a basic template that may be adopted and adapted by hospitals to underpin their body release process. It may also be suitable for adaptation, in consultation with the local coroner’s office, for use in other settings. The consultation closes on 6 April 2015.

News
Innovating for Improvement. The Health Foundation is looking for projects that aim to improve health care delivery and/or the way people manage their own health care. A share of £1.5m funding is available for up to 20 teams to test and develop innovative ideas to improve health care delivery in the UK. Each team will receive up to £75,000 of funding over 15 months, to support the implementation and evaluation of their health care innovation project. The closing date for applications is 10 February 2015.

Eleven new centres to lead genomics project. Announces the 11 new centres across England that have been chosen to deliver the 100,000 Genomes Project, which aims to improve diagnosis and treatment for patients with cancer and rare diseases. The initiative involves collecting and decoding 100,000 human genomes that will enable scientists and doctors to understand more about specific conditions.

NHS doctor first to stand trial for female genital mutilation. Dr Dhanuson Dharmasena, an NHS hospital doctor, has became the first person to stand trial for female genital mutilation after being accused of illegally stitching up a young woman who had just given birth to her first child. On the first day of his trial, the prosecution claimed that Dr Dharmasena changed his story when it became a police inquiry, telling officers that the procedure was medically justified.

Health bodies commit to ending LGB conversion therapy. A memorandum of understanding on conversion therapy in the UK has been created by the UK Council for Psychotherapy, with support from the Department of Health and 14 other signatory organisations, to secure an end to the practise of conversion therapy in the UK. The memorandum clarifies that NHS England will be committed to ensuring that it does not endorse or support conversion therapy for lesbian, gay and bisexual (LGB) people.

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