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
Emergency Care Providers
Employment/HR Public Health
Finance Regulation
Foundation Trusts General


Emerging practice in outcome-based commissioning for social care. This paper from Oxford Brookes University's Institute of Public Care explores the lessons learnt from a variety of approaches taken by councils to outcome-based commissioning in adult social care ('payment by results'). It considers some of the opportunities and risks that arise from taking this approach. The paper puts the emerging practice in social care in a context with other developments within the public sector, explores current practices in social care from a small number of councils and looks at the advantages and risks in taking this approach. It suggests that this approach could deliver better outcomes for people at a lower cost if the transaction costs can be limited.

Disabled facilities grant funding via Better Care Funds – An opportunity to improve outcomes? Care & Repair England has published a briefing which explains the changes in the way that national funding for disabled facilities grants is paid. The Better Care Fund will receive the money and the allocation then needs to be passed on to the relevant Housing Authority (in two tier areas) or Department (in unitary authorities). The briefing clarifies responsibilities and highlights opportunities for integration.

Care after death. First published in 2011, the 'Guidance for staff responsible for care after death' showed that care after death is the first stage of a process which involves a range of professional groups and that coordinated working is vital if the process is to run smoothly. Endorsed by three royal colleges and other national organisations, the focus of the second edition has been extended to include recommendations relating to the training of staff and to addressing deaths in mental health services and prisons. Author: Jo Wilson on behalf of National Nurse Consultant Group (Palliative Care). 

What are the parties promising on health and social care? The King's Fund has set up an Election 2015 website that looks at some of the big questions in health and social care and sets out the policies and pledges made by the main parties in England.

Equity in the provision of palliative care in the UK: Review of evidence. This literature and evidence review, produced by the LSE's Personal Social Services Research Unit and funded by Marie Curie, found that a significant minority of people – at least a fifth of everyone who dies – are not receiving the palliative care they need; it also found that some groups are less likely to receive this care than others. The study maps what is happening, to see if there are inequities in access and outcomes, rather than to look closely at causes; however, it identifies a range of service gaps that need to be addressed.

Principles for maintaining continuity of care when moving across borders within the United Kingdom. These principles set out how responsible authorities should ensure continuity of care for adults who receive care and support and move to another country within the UK. They aim to make continuity of care work across the UK’s borders by setting out clear values in good practice. Local authorities working together and involving the person moving should ensure that people can have confidence that their needs continue to be met when they move.

Vital signs: Taking the temperature of health and care services for people living with long term conditions. The Richmond Group of Charities has revisited its 2012 joint report 'How to deliver high-quality, patient-centred, cost-effective care' that set out what matters most to people living with long term conditions, their families and carers. This update looks at where we are now. It brings together information and evidence from across the system to provide a unique snapshot of the current gaps in care for those living with long term conditions in England today.

Working together to safeguard children – A guide to inter-agency working to safeguard and promote the welfare of children.. Revised statutory guidance setting out the legislative requirements and expectations on individual services to safeguard and promote the welfare of children. It also provides a clear framework for Local Safeguarding Children Boards (LSCBs) to monitor the effectiveness of local services. The major changes to the guidance cover: the referral of allegations against those who work with children; notifiable incidents involving care of a child; and clarification of the term ‘seriously harmed’.
DfE has also published other non-statutory guidance alongside this document:
 What to do if you’re worried a child is being abused: advice for practitioners
 Information sharing: advice for practitioners providing safeguarding services
 Keeping children safe in education: for schools and colleges 

Practical guide to engaging with health and wellbeing boards. This guide for voluntary organisations provides practical steps to follow to develop relationships with Health and Wellbeing Boards. The briefing is part of a series aimed at supporting voluntary organisations to work better with local commissioning bodies.
There is also a guide for voluntary organisations on Engaging with clinical commissioning groups.

Accessing care in 2016 and beyond: a step-by-step guide for over 65s. London Councils has developed a step by step guide for over 65s which sets out using a flow chart how the Care Act funding reforms are likely to impact on whether they will qualify for support from their council or not.

CQC welcomes launch of the Care Certificate from April. The Care Quality Commission (CQC) has published information that sets out what it expects from health and social care providers ahead of the introduction of a new Care Certificate from 1 April 2015. The Care Certificate has been produced to address inconsistencies in training and competencies in the workforce.

Equal measures: equality information report for 2014. This report summarises lessons learnt about equality and diversity, both across health and social care and internally at CQC last year. It finds that while seeing some improvements, there is still too much variation in people’s access, experience and outcomes in many health and social care services. For example, the fact that more ethnic groups seem to use certain hospital services more than other groups suggests that access could be an issue. It also finds that people with dementia have poorer outcomes in hospitals than those without dementia going into hospital for the same health conditions; and, that the needs of people with visual impairment and hearing loss within care homes are sometimes overlooked.

NHS funded nursing care rates increased from 1 April 2015. Announces that the NHS contribution towards the costs of a place in a care home with nursing - for people assessed as requiring the help of a registered nurse - is being increased by 1% for 2015/16. From 1 April 2015, the standard rate for eligible care home residents assessed to require the help of a registered nurse will be £112pw; the higher rate will be increased to £154.14pw.

New social impact bonds to support public services. Announces seven new Social Impact Bond investment schemes to help disadvantaged young people, children in care and those with long term health conditions and mental illness.

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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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.

Regulation 5: fit and proper persons: directors - information for NHS bodies. The intention of this regulation is to ensure that people who have director level responsibility for the quality and safety of care, and for meeting the fundamental standards are fit and proper to carry out this important role.

Duty of candour: guidance for surgeons and employers. This best practice guide describes how to implement the principles of duty of candour in everyday practice. It outlines steps that surgeons should take on an individual level, to ensure that the principles of the duty of candour are at the forefront of everyday work. It reflects the profession’s commitment towards creating greater openness and transparency in the NHS. This guide is being released following the coming into force of the Duty of Candour legislation in late November 2014 and its amendments in April 2015. It expands on the principles of the College’s Good Surgical Practice and aims to support surgeons to meet their professional and legal duties.

The handling by the General Medical Council of cases involving whistleblowers. An independent review by Sir Anthony Hooper recommends that organisations referring concerns about a doctor’s fitness to practise to the GMC should declare whether the doctor has raised concerns about patient safety. The report says there is evidence that those who raise concerns may suffer, or believe that they suffer, reprisals from their employer or from colleagues. He proposes a series of recommendations for GMC investigations to make sure that such whistleblowers are treated fairly. Sir Anthony says the key to minimising the risk that the GMC unwittingly becomes the instrument of the employer in a campaign against a doctor is an understanding of the background to the allegation.

Partnering to improve quality and safety: a framework for working with patient and family advisors To truly transform care, hospitals and care systems must effectively engage patients and their families. This guide presents a framework for one powerful way to engage patients – as advisors on quality and patient safety initiatives. The Symposium for Leaders in Healthcare Quality developed this guide to help hospitals and care systems build and sustain partnerships with patient and family advisors, specifically to improve quality and safety.

Uses and abuses of performance data in healthcare. This report describes how efforts to improve standards of patient care in the NHS are being undermined by performance measures that encourage ‘gaming’ and sap professional motivation. It makes a series of recommendations to tackle practices that distort the reliability of the information used to manage the standards of care delivered to patients. It outlines how better healthcare data from English hospitals has led to greater transparency.

Frontline first: the fragile frontline. This report finds that there are fewer nurses than in 2010 and that an already over-stretched workforce is being forced to carry out even more work, with serious implications for patient care and staff welfare. It also highlights other areas for the next Government to consider such as the decrease in numbers in the community nursing workforce and cuts to student nursing places.

Raising concerns: Guidance for nurses and midwives. Raising concerns provides guidance for nurses and midwives on raising concerns. It sets out broad principles that will help them think through the issues and take appropriate action in the public interest. It was published in 2013 and was updated to reflect the new Code in 2015.

NHS Continuing Healthcare: Refreshed redress guidance. NHS England has published the finalised refreshed Redress Guidance for NHS Continuing Healthcare for CCGs that now reflects guidance from the Parliamentary and Health Ombudsman for all public sector bodies, on calculating interest on redress payments. The guidance assists CCGs when settling claims for individuals arising from NHS Continuing Healthcare eligibility decisions or where an eligibility decision has been reached on a previously un-assessed period of care in respect of NHS Continuing Healthcare and the need for redress has been identified. It retains the principle of returning the individual to the financial position they would have been in had they been assessed as eligible and the need for redress identified. CCGs will continue to consider the specific circumstances of individual cases, as they do now, to ensure that all individuals are returned to the financial position they should have been in, if redress is considered appropriate.

Government response to the House of Commons Health Select Committee Fourth Report of session 2014–15 Complaints and Raising Concerns. This report outlines the way the Government wants to create long lasting cultural change across the health and social care system. The Government believes that improving the way in which the NHS manages and responds to complaints will help shape a culture that listens to and learns from patients and service users, and ends a culture of defensiveness.

Investigating clinical incidents in the NHS: Sixth Report of Session 2014-15: Report, together with formal minutes relating to the report. A Public Administration Select Committee report concludes there is a need for a new, permanent and simplified system for effective local clinical incident investigation conducted by trained staff, so that facts and evidence are established early, without the need to find blame, and regardless of whether a complaint has been raised. This would reduce or remove the need for costly inquiries into clinical failure.

Professional standards of practice and behaviour for nurses and midwives. The Code has been updated to reflect changes in contemporary professional nursing and midwifery practice and to reflect the public expectations of care.

Managing medical devices. Guidance from the Medicines and Healthcare Products Regulatory Agency on a systematic approach to the acquisition, deployment, maintenance (preventive maintenance and performance assurance), repair and disposal of medical devices. It also gives guidance on medical device training. It is intended for people in hospitals and community-based organisations that are responsible for the management of reusable medical devices.

Health and Social Care (Safety and Quality) Act 2015. This Act has received Royal Assent and comes into force on a day (or days) to be appointed. The Act contains measures that together are intended to improve the safety and quality of health services and social care. In particular, it seeks to ensure that certain health and social care-related services in England cause their users no avoidable harm; makes provision for requiring the use of a consistent service user identifier in individuals’ health and social care records in England; and is intended to secure the appropriate sharing of information in support of people’s direct care in England to help ensure more integrated care. It also gives the various regulators of health and social care professionals an overarching objective of public protection.

Health Service Commissioner for England (Complaint Handling) Act 2015. This Act has received Royal Assent and comes into force on 26 May 2015. It seeks to increase the effectiveness of the the Health Service Ombudsman by requiring the her to take action with a view to concluding investigations of complaints within 12 months. In any case where this timescale is not met, she must inform the complainant of the reason why not.

Health Care and Associated Professions (Knowledge of English) Order 2015 (SI 2015/806). This Order, which comes into force on 20 March 2015, amends the Nursing and Midwifery Order 2001, the Dentists Act 1984, the Pharmacy Order 2010 and the Pharmacy (Northern Ireland) Order 1976 to strengthen the relevant regulatory bodies’ powers to introduce proportionate controls and require European applicants to provide evidence of their knowledge of the English language following recognition of their qualification, but before registration and admission onto the register. It also makes corresponding amendments to the fitness to practise powers of the NMC, GDC, GPhC and PSNI, to ensure that not having the necessary knowledge of the English language becomes a ground for taking fitness to practice proceedings in its own right, instead of the regulators having to wait until this causes deficient professional performance in practice.

Bevan Brittan Articles
Duty of Candour Thresholds - Clarity for Independent Healthcare Providers The amendments to the NHS Standard Contract in the newly released 2015/16 version provide welcome clarity for independent healthcare providers providing NHS services over the question of when their duty of candour to patients is triggered.

Bevan Brittan Events
Inquest Update Seminar 18 June 2015 : 10:00 - 13:00 (registration opens at 09:30 and the event will be followed by networking lunch) Location: Bevan Brittan, Fleet Place House, 2 Fleet Place, Holborn Viaduct, London, EC4M 7RF. Bevan Brittan’s Inquest Update will provide a review of recent case law and guidance from the Chief Coroner as well as an update on the progress and effect of the implementation of the Coroners and Justice Act 2009. This session is a great opportunity to join an interactive session and share experiences.

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

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Mapping between different commissioners of healthcare. This paper sets out how the NAO created look-up files to map between different commissioning geographies. This enabled it, for example, to estimate overall health funding at an area-level despite the different geographical bases of the various commissioners. The paper provides links to these look-up files.

CCG Assurance Framework 2015/16. The new framework describes the assurance process which supports CCGs to commission safe, high quality and cost effective services for patients. It includes a strengthened focus on a CCG’s performance in delivering improvements for patients, as well as assessment of its capability to deliver core and additional delegated responsibilities.

2015/16 NHS standard contract. NHS England has published the NHS Standard Contract which must be used by commissioners for all contracts for healthcare services other than primary care. It again comprises three parts: Particulars, Service Conditions and General Conditions. The web page also links to technical guidance, National Variations, CQUIN guidance and other contract support documents. There are also Delta View comparison documents showing the changes made from the 2014/15 version of the Contract to the 2015/16 version.

NHS Outcomes Framework 2015 to 2016. Sets out the outcomes and corresponding indicators that will be used to hold NHS England to account for improvements in health outcomes. 

Cataract commissioning guidance. Guidance from the Royal College of Ophthalmologists issued in response to public concern that wide variations across the country in commissioning policy for the treatment of cataract was effectively creating a "postcode lottery" and may be denying or delaying access to cataract surgery to some patients who need it.

A toolkit to support NHS commissioners to reduce poor experience of in-patient care. This toolkit has been developed to support NHS commissioners to work collaboratively with patients, carers and NHS provider organisations to reduce poor experiences of in-patient care. It is the first in a series and is made up of three core elements: a data tool to help commissioners identify priority areas to focus on in order to improve in-patient experience; case examples to illustrate improvement work undertaken by organisations; and signposting to relevant improvement tools.

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

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Emergency Care

Acute hospitals and integrated care: From hospitals to health systems. This King's Fund report describes lessons from five case studies where acute hospitals are working collaboratively with local partners to build integrated models of care – three of these sites have since been chosen as vanguards by NHS England. The report assesses the achievements made so far, distils the lessons learnt for other local health economies, and makes recommendations for national policy-makers.

Modelling of maternity services in England. This paper is part of a series of papers that summarise the methodological approaches the NAO has taken in carrying out innovative or novel analysis. It sets out how the NAO used a modelling technique called ‘discrete event simulation’ to investigate a local maternity service.

Urgent repeat medication requests: Guide for NHS 111 services. Provides details on how NHS 111 services can establish a direct referral to a pharmacy that is commissioned to provide urgent repeat medication as a local NHS service. The patient journey ensures the patient is directed to the nearest pharmacy without the need of a GPOOHs assessment and the pharmacist ensures the governance of the process is adhered to by informing the patient’s GP of any repeat supply. Commissioners of NHS 111 services and local community pharmacy services are encouraged to use this guide to inform the transformation of urgent care by shifting the burden of repeat medication requests away from GPOOHs services and other urgent care settings.

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

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Publications and Guidance
The handling by the General Medical Council of cases involving whistleblowers. An independent review by Sir Anthony Hooper recommends that organisations referring concerns about a doctor’s fitness to practise to the GMC should declare whether the doctor has raised concerns about patient safety. The report says there is evidence that those who raise concerns may suffer, or believe that they suffer, reprisals from their employer or from colleagues. He proposes a series of recommendations for GMC investigations to make sure that such whistleblowers are treated fairly. Sir Anthony says the key to minimising the risk that the GMC unwittingly becomes the instrument of the employer in a campaign against a doctor is an understanding of the background to the allegation.

Work and wellbeing in the NHS: why staff health matters to patient care. This report by the Royal College of Physicians sets out why it is in the best interests of both patients and NHS organisations for the health, well-being and engagement of the NHS workforce to be prioritised. Building on the Future Hospital Commission’s 2013 recommendation that staff should be supported to deliver safe, compassionate care, the report offers a call to action to UK governments, NHS trusts, health boards, commissioners and medical royal colleges to take urgent action in the interest of patients, staff and services. The report shows that staff health and wellbeing in the NHS is too often seen as an optional extra - as less than two thirds of trusts have a staff health and wellbeing plan in place. It explains that investment in NHS staff is not an optional extra, but a vital investment in safe, sustainable patient care.

Frontline First: The fragile frontline. This RCN report finds that there are fewer nurses than in 2010 and that an already over-stretched workforce is being forced to carry out even more work, with serious implications for patient care and staff welfare.

Professional standards of practice and behaviour for nurses and midwives. The Code has been updated to reflect changes in contemporary professional nursing and midwifery practice and to reflect the public expectations of care.

Bevan Brittan Events
 Employment law workshop: managing difficult grievances - London.13 May 2015 : 10:00 - 12:30 ( registration opens at 09:30). Location: Bevan Brittan, Fleet Place House, 2 Fleet Place, Holborn Viaduct, London, EC4M 7RF
 Employment law workshop: managing difficult grievances - Birmingham 14 May 2015 : 10:00 - 12:30 (registration opens at 09:30) Location: Bevan brittan LLP, Interchange Place, Edmund Street, Birmingham , B3 2TA

Our interactive case-study led employment law workshop will explore a number of scenarios and provide practical strategies for managing what are often complex, protracted and challenging grievance processes. 'Mary' – our fictional Accounts Assistant raises a myriad of issues, complaints and concerns involving her colleagues, detailed information requests, and policy and procedural considerations, which warrant a formal investigation. This session will give you an opportunity to share experience and best practice and gain insight into successfully navigating the various workforce issues to be considered, whilst maintaining effective team relationships and minimising the risk that the process does not take over and drain resources away from the team's primary service delivery tasks.

Workforce Forum 19 May 2015 : 18:00 - 19:30 (registration opens at 17:30) Location: Bevan Brittan, Fleet Place House, 2 Fleet Place, Holborn Viaduct, London, EC4M 7RF. Bevan Brittan's Workforce Forum is an interactive discussion forum for Workforce and Organisational Development Directors focusing on strategic workforce issues in the healthcare sector.

Developing Future Workforce Leaders 02 June 2015 : 17:30 - 19.30 (the session will be followed by a networking drinks reception) Location: Bevan Brittan, Fleet Place House, 2 Fleet Place, Holborn Viaduct, London, EC4M 7RF. This is an evening event aimed at deputy HR directors and HR business partners who are members of HPMA, and it is part of the regular programme Bevan Brittan run jointly with HPMA. One of the most challenging areas for HR professionals in the health sector is the management of concerns about doctors and particularly, in the NHS, the application of the provisions and guidance set out in Maintaining High Professional Standards in the Modern NHS Framework(MHPS).

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

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An update on Hinchingbrooke Health Care NHS Trust. This report recommends that the Department of Health and the NHS Trust Development Authority should report to the Committee on the total cost to the taxpayer arising from the failure of the franchise, including the costs of transition arrangements and the total cost of covering the financial deficits incurred during the franchise. It also suggests that the Department of Health and the NHS Trust Development Authority should ensure that strong governance and clear accountabilities are put in place for future novel or high-risk ventures, and that there is strong and effective monitoring.

Hospital finances and productivity: in a critical condition? This report from the Health Foundation examines the financial performance of NHS providers, focusing on hospitals. It identifies areas of cost pressure using their financial accounts up to 2013/14 and quarterly reporting data up to December 2014 (Q3 2014/15). It also examines trends in efficiency and productivity from 2009/10 to 2013/14.

Quarterly monitoring report: issue 15. This report examines the views of finance directors on the productivity challenges they face, as well as some key NHS performance data to see how the NHS is performing. As the NHS begins a new financial year and we move from one parliament to another, it is clear from the performance on key headline targets and standards and from our latest survey of finance directors that the NHS will face huge challenges this year.  

The efficient management of healthcare estates and facilities. DH has published guidance for NHS trusts, foundation trusts and other NHS organisations on achieving efficiency savings and reducing costs in NHS estates. It is split into two parts: Part A outlines how efficiencies in the running of land and property can be achieved, while Part B provides more detailed advice about the active management of land and buildings used for healthcare services. Addendums to the building note provide guides to: town planning for health organisations and the healthcare system in England for local planning authorities.

Economic and fiscal outlook. This report sets out forecasts for the economy and the public finances over a five year horizon and assesses whether the Government is on course to hit its fiscal targets.

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

Well-led framework for governance reviews: guidance for NHS foundation trusts. Statutory guidance by Monitor sets out how NHS foundation trusts should carry out reviews of their governance and explains how NHS trusts applying for foundation trust status can use the well-led framework. 

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

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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.

Law Society Guidance: Deprivation of Liberty. The Law Society has issued comprehensive guidance on the law relating to the deprivation of liberty safeguards. The safeguards aim to ensure that those who lack capacity and are residing in care home, hospital and supported living environments are not subject to overly restrictive measures in their day-to-day lives.

Voting rights for mental health patients. Guidance from Royal College of Psychiatrists and Central and North West London.

Statutory guidance for local authorities and NHS organisations to support implementation of the Adult Autism Strategy. This statutory guidance shows how local authorities and NHS organisations should carry out their responsibilities under the Autism Act 2009 to develop services that support and meet the needs of people with autism, and their families and carers. It also explains what support they can expect to receive from local authorities and NHS organisations. The guidance has been revised to reflect changes to support the implementation of the strategy for adults with autism in England since 2010. See also Draft revised statutory guidance to implement the strategy for adults with autism in England – Government response to consultation.

Mental health aftercare in England and Wales. From 1 April 2015 the local authority responsible for mental health aftercare services, under section 117 of the Mental Health Act 1983 (the Act), will normally be the one where the person was ordinarily resident immediately before they were detained under the Act. This document has details about arrangements for referring disputes over ordinary residence in cases where one or more authority in dispute is in England and one or more is in Wales. These arrangements only apply where services are provided under section 117 of the Act.

Mental Health Act code of practice. A revised code of practice for the Mental Health Act 1983 provides guidance for professionals came into force on 1 April. The code shows professionals how to carry out their roles and responsibilities under the Mental Health Act 1983, to ensure that all patients receive high quality and safe care.

Reference guide to the Mental Health Act 1983. A new Reference Guide was published in England to coincide with the coming into force of the new Code of Practice on 1 April 2015. It is a reference source for people who want to understand the main provisions of the Mental Health Act 1983 and the regulations under the Act, as amended, including by the Mental Health Act 2007, Health and Social Care Acts 2008 and 2012 and Care Act 2014. The revised reference guide complements the revised Mental Health Act Code of Practice, with the Code giving guidance on how the Act should be applied.

Care services for people with learning disabilities and challenging behaviour. Too many children and adults with learning disabilities are being kept in mental health hospitals unnecessarily because of the lack of community alternatives, according to the Public Accounts Committee. The committee expressed concern at the lack of action being taken to close hospitals and prevent people being put into institutions. However, it welcomes a new closure programme expected to be run by NHS England, setting out recommendations on how to close large mental health hospitals and develop effective transition arrangements for patients.

Dementia-friendly health and social care environments (HBN 08-02). Sets out design principles for dementia-friendly environments in new healthcare buildings, and in the adaptation or extension of existing facilities. The design principles, core design features and a selection of case studies provide guidance for the development of new design solutions and the adaptation or extension of existing facilities. The guide includes case studies from the Dementia Friendly Environments Programme.

Preventing deaths in detention of adults with mental health conditions. This inquiry reveals that despite many reports and recommendations, serious mistakes have gone on for far too long. The same errors are being made time and time again, leading to deaths and near misses.

Independent Mental Health Advocacy (IMHA). This suite of 12 resources includes short films, reports, at a glance summaries and tools. Some of the resources aim to raise service users’ and mental health staffs’ awareness and understanding of the IMHA role, and address equality of access. Others help advocacy providers, commissioners and mental health trusts to improve access to IMHA, to understand what a good service looks like, and how outcomes can be measured.

Future in mind: Promoting, protecting and improving our children and young people's mental health and wellbeing. The report of the Children and Young People's Mental Health and Wellbeing Taskforce makes recommendations on ways to make it easier for children, young people, parents and carers to access help and support when needed and to improve how children and young people's mental health services are organised, commissioned and provided. Recommendations include: improved access for children and young people who are particularly vulnerable; improved access to support through named points of contact in specialist mental health services and schools; and waiting time standards.

Bevan Brittan Events
Annual Mental Health Seminar - Click on any of the links below to register your interest
London - 5 May
Birmingham - 6 May
Bevan Brittan's mental health team are delighted to invite you to our Annual Mental Health Seminar. The pace of change in mental health law has given rise to a range of challenges for mental health professionals, both clinical and in management. This seminar will give an outline of what those changes mean for day to day practice as well as how they will affect the structure and policy behind mental healthcare provision.

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

PCC has published a summary of the GMS contract changes 2015/16. The briefing covers changes to the core contract and enhanced services.

The future of general practice - survey results. A major BMA survey of the medical profession shows how GP practices are 'close to breaking point'. The survey, which is part of the BMA's No More Games campaign, also finds that only one in 10 GPs feels a 10-minute consultation is adequate.

NHS Primary Medical Services Directions. The DH has published four new Directions that set out the legal framework under which GPs operate and are paid:
 General Medical Services Statement of Financial Entitlements (Amendment) Directions 2015
 Primary Medical Services (Directed Enhanced Services) Directions 2015
 Alternative Provider Medical Services (Amendment) Directions 2015
 National Health Service Litigation Authority (Primary Medical Services: General Practice Systems of Choice: CCG Practice Agreement: Dispute Resolution) Directions 2015

Building primary care in a changing Europe. This publication analyses the way how primary care is organised and delivered across European countries, looking at governance, financing and workforce aspects and the breadth of the service profiles. It describes wide national variations in terms of accessibility, continuity and coordination. Relating these differences to health system outcomes the authors suggest some priority areas for reducing the gap between the ideal and current realities.

CQC inspectors publish reports on 52 more GP practices. The Care Quality Commission (CQC) has published a further 52 reports on the quality of care provided by GP practices. In its latest inspections, the regulator has rated one practice as outstanding, 39 as good, while five require improvement.

GP evening and weekend appointments to increase. Announces an extra £550m funding to improve access to GPs, modernise GP surgeries and improve out-of-hospital care.

New package to attract doctors to Wales. The Welsh Government has announced new arrangements that will make it easier for GPs who have previously worked in Wales to return to practice following a career break or a period of working outside the UK. They will also support doctors who have qualified outside the UK and choose to work in Wales.

Pharmacists set to work in GP surgeries in radical move to ease pressures on general practice and improve patient care. The Royal College of General Practitioners (RCGP) and the Royal Pharmaceutical Society (RPS) have come up with plans for pharmacists to work in GP surgeries, in a bid to ease current pressures in general practice and address the severe shortage of GPs. They say that the move will improve patient safety and care and, crucially, reduce waiting times for GP appointments. The proposals would see pharmacists working as part of the general practice team, much in the same way as practice nurses. They would work closely with GPs and other colleagues to resolve day to day medicine issues, particularly for patients with long term conditions and who are taking a number of different medications. They would also liaise with hospitals, community pharmacists and care homes to ensure seamless care for patients.

CQC inspectors publish reports on 95 more GP practices. The Care Quality Commission has published a further 95 reports on the quality of care provided by GP practices that have been inspected under its new approach.

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

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The NHS terms and conditions for the supply of goods and the provision of services: Guidance. Updated guidance on the NHS terms and conditions that are for the use of NHS bodies procuring goods and services from commercial organisations, not for the procurement of clinical services from other NHS bodies or independent sector providers.

Procurement transparency. Guidance to all NHS FTs and non-FTs 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. The actions focus on: opening up public procurement; being transparent about expenditure; and sharing expenditure data.

Procurement and competition rules: Can the NHS be exempted? In this briefing, the King’s Fund seeks to clarify whether a new government could extract the NHS from European Union procurement and competition rules. The briefing concludes that it is not possible to exempt the NHS from EU procurement and competition law. It does, however, suggest that the same aim could be achieved by making broader changes to policy, including bringing foundation trusts clearly back under the direct control of government.

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

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Integrated care licence condition: guidance for providers of NHS-funded services. This guidance is for licensed providers of NHS-funded services in England and NHS trusts and it explains what is expected of NHS providers in relation to the integrated care licence condition and where Monitor may take action.

NHS Confederation Form follows function: governance challenges for providers in light of the Dalton review. This joint NHS Providers and NHS Confederation report explores the governance implications of the different organisational forms proposed in Sir David Dalton’s review of organisational forms. The report focuses on governance as a critical factor in determining success and explores the governance implications of adopting different organisational forms for the purposes of improving quality and efficiency, and provides some core questions for provider boards to use to inform their thinking.

Protecting and promoting patients’ interests licence exemptions: Guidance for providers. This updated guidance reflects the changes made by the National Health Service (Licence Exemptions, etc) Amendment Regulations 2015 (SI 2015/190) that come into effect on 1 April 2015. Monitor will also be updating their guidance on Commissioner Requested Services and so this section has also been updated to reflect this. NHS providers are responsible for determining if they are exempt, and for applying to Monitor for a licence if they are required to hold one. This guidance helps providers of NHS services understand whether they need a licence, or if they are exempt from the requirement to hold a licence. 

Form follows function: Governance challenges for providers in light of the Dalton review. This joint NHS Providers and NHS Confederation report explores the governance implications of the different organisational forms proposed in Sir David Dalton’s review of organisational forms, published in December 2014. While many of the organisational forms proposed in the Dalton review have been explored by a number of providers, the concept of a management chain or group structure remains unfamiliar in the English NHS. Crucially, there is limited guidance available about how NHS providers can put in place robust governance structures and local accountabilities to help ensure the benefits articulated in the business case are realised in practice. 

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

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Public Health

Transfer of 0-5 children’s public health commissioning to local authorities – 0-5 Public Health Allocations for 2015/16. Revised details of the final allocations for almost all local authorities to commission children’s 0-5 public health services in the six-month period from 1 October 2015 to 31 March 2016.

LGA: Local solutions, healthy lives: Council's role in drug and alcohol services. Describes how public health in a number of councils has started to use the opportunities of a local government setting to improve health and wellbeing. The eight case studies show a range of ways in which public health in councils is approaching drug and alcohol services.

Commissioning services to support women and girls with female genital mutilation. This document sets out what some elements of a successful and safe service to support women and girls with female genital mutilation (FGM) might look like. It has been developed in partnership with healthcare professionals currently involved in providing healthcare services, and it aims to highlight what commissioners might want to consider when developing a new service. It can be used by any healthcare commissioners, by CCGs, area teams and service development leads.
See also Female genital mutilation risk and safeguarding: Guidance for professionals that provides guidance to support an NHS organisation when they are developing or reviewing safeguarding policies and procedures around FGM. It can be used by health professionals from all sectors, particularly designated and named safeguarding leads, and local safeguarding children board members. It is based on existing best practice within the NHS.

Living well for longer: One year on. Shows progress against the actions set out in Living Well for Longer: National support for local action which followed a call to action from the Secretary of State. The report shows that there has been improved prevention, early diagnosis and treatment of the big killers: Cancer; Stroke; Heart disease; Lung disease and Liver disease. It also outlines the next steps for ongoing improvements across the system in reducing premature mortality.

Better health for London: Next steps. The Mayor of London, NHS England, Public Health England, London Councils and the 32 GP-led clinical commissioning groups have come together to outline how, individually and collaboratively, they will work towards London becoming the world's healthiest major city. This document sets out shared ambitions and how they will measure progress towards the 10 shared goals.

Action plan on hearing loss. NHS England and DH have produced an Action Plan to support services for deaf people and those with diminishing hearing. The plan has been developed with a number of organisations including Public Health England, hearing loss charities and those whose hearing is directly affected. Aimed at commissioners, CCGs, GPs and healthcare providers, the report identifies multiple health and social issues associated with hearing loss. It recommends ways that services for children, young people, working age and older adults living with hearing loss can be improved.

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

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Our approach to regulating: health and social care in prisons and young offender institutions, and health care in immigration removal centres. In October 2014 the CQC published a signposting statement, Inspecting Together, developing a new approach to regulating healthcare in prisons, young offender institutions and immigration removal centres. Since then they have engaged with internal and external stakeholders to develop a joint inspection framework with HM Inspectorate of Prisons (HMIP) and are now formally consulting on that approach. This joint approach will support CQC and HMIP to develop a holistic and coherent view of health within secure settings. The consultation closes on 24 May 2015.

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

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NHS England Business Plan 2015/16. This business plan describes the organisation’s headline goals and priorities to ensure both high quality care for the people of England and efficiency for the taxpayer. The 10 priorities are chosen to deliver the main themes of the Government’s mandate, while advancing the agenda the NHS has set for itself in the NHS Five Year Forward View.

Real world testing of 'combinatorial innovation': A global invitation to innovators. NHS England and the UK Government are calling for expressions of interest from innovators from any sector in the UK and overseas who want to test their ideas to deliver health services in better ways at scale, and in a real clinical setting. The call for expressions of interest opens on 26 March 2015 and runs until 29 May 2015. This 'test bed' prospectus explains how innovators should express interest, and the process to follow over the coming months to select the final projects.

Guidance on implementing the overseas visitor hospital charging regulations 2015. DH guidance provides help and advice on the implementation of the National Health Service (Charges to Overseas Visitors) Regulations 2015. It explains what should happen when an overseas visitor needs NHS treatment provided by an NHS hospital in England.

NHS car-parking management: environment and sustainability (HTM 07-03). This Health Technical Memorandum helps NHS organisations identify best practice in car-park management and sustainable transport. It advises on how to deliver the DH's car-parking principles, which provide clear and consistent ground rules that will help manage car-parking provision in the NHS and help to improve the patient experience across the NHS.

Making energy work in healthcare (HTM 07-02). This Health Technical Memorandum provides guidance on managing responsible energy use within the health sector. It draws together best practice guidance and background information regarding energy use in the healthcare sector. It provides information on mandatory requirements by legislation, best practices in energy efficiency, as well as relevant case studies. It is in two parts: Part A covers policy and management, and Part B sets out procurement and energy considerations for new and existing building facilities.

NHS charities: Conversion to independent status – Outline guidance. In accordance with the Review of the regulation and governance of NHS Charities, published in March 2014, trustees of NHS Charities can establish a new charity independent of the DH. This updated guidance for the trustees of NHS Charities explains the process for trustees considering independence. It explains variations that are dependent upon the structure of the NHS Charity, and the necessary engagement with the Department and the Charity Commission. 

Genital piercings to be recorded as FGM. Under NHS rules due to come into force in April 2015, women who have genital piercings will be recorded as having suffered female genital mutilation (FGM). It is reported that the mandatory recording regulations will even apply to consenting women who had the procedure for cosmetic reasons. Piercing and incising were classified as "harmful procedures" and forms of FGM by the World Health Organisation in 2014 guidelines.

Minister announces £3 million funding for stem cell services. The funding will support a partnership between NHS Blood and Transplant (NHSBT) and blood cancer charity Anthony Nolan. 

Bevan Brittan Updates
Home Office publishes Code of Practice for public authorities on data sharing and fraud prevention. On 23 March 2015 the Home Office published its snappily-titled Code of practice for public authorities disclosing information to a specified anti-fraud organisation under sections 68 to 72 of the Serious Crime Act 2007 (the Code).

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