28/08/2015
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 |
| Clinical Risk/Health and Safety | Mental Health |
| Commissioning | Primary Care |
| Emergency Care | Public Health |
| Employment/HR | Regulation |
| Finance | General |
Care
Publications/guidance
Social care: paying for care home places and
domiciliary care (England). This Commons research briefing sets
out the means test that applies to care home residents and those in
other settings (such as care at home) in need of social care, and
provides information on personal budgets.
One chance to get it right: one year on report.
This report shows the progress organisations have made on specific
commitments in the One Chance To Get It Right report, which set out
actions to improve care in the last days and hours of life. It sets
out progress made on: the new Care Quality Commission inspection
regime for end of life care; new NICE guidance; actions to improve
education, training and research; professional regulation; and the
implementation of the priorities for care.
PIP Assessment Guide: A DWP guidance document for
providers carrying out assessments for Personal Independence
Payment. Personal Independence Payment (PIP) is a benefit for
people with a long-term health condition or impairment, whether
physical, sensory, mental, cognitive, intellectual, or any
combination of these. It is paid to make a contribution to the
extra costs that disabled people may face, to help them lead full,
active and independent lives. This updated guidance supplements the
contract documents agreed with providers as part of the commercial
process. It provides guidance for health professionals carrying out
PIP assessment activity and for those responsible for the quality
of assessments.
Delay in the implementation of the cap on care
costs. Letter from Care and Support Minister Alastair Burt
announcing that, in response to concerns expressed by the Local
Government Association and many other stakeholders about the
timetable for implementing the cap on care costs in April 2016, the
Government has decided to delay its implementation until 2020. The
delay will allow time to be taken to ensure that everyone is ready
to introduce the new system and to look at what more can be done to
support people with the costs of care.
Viewpoint: Reconsidering accountability in an age
of integrated care. In this paper authored for the Nuffield
Trust, Ben Jupp, Visiting Senior Fellow and former director of
public service reform at the Cabinet Office, examines the future of
governance and accountability in the NHS and social care amid the
rise of new provider models, a growing focus on integration and
deep cuts in council funding. He argues that the purchaser-provider
split, after 25 years, will lose its position as the cornerstone of
NHS structure and accountability under these developments. If the
health service is to remain fit for purpose, the paper stresses the
need for these new providers to be held to account in new ways.
New Care Models: update and initial support. The NHS Five Year Forward View partners have published a support package for the new models of care vanguards which were launched in March 2015. The 29 vanguards were selected following a rigorous process involving patients, clinicians and peer review, and will initially improve the care provided to more than 5m people. Building on the best practice already being displayed, the support package is designed to be led by vanguard leaders alongside national experts, and aims to help the vanguards be as successful as possible in making the changes they are planning. It is also intended to maximise sharing of learning and practice across the 29 vanguards and, importantly, with the wider NHS and care system – a key element of the vanguards’ work.
Consultations
Care of the dying adult: draft guideline
consultation. NICE has launched a consultation on a draft
guideline to support the NHS in providing high quality and
compassionate care for people who are dying, to help doctors and
nurses identify when someone is entering their final few days of
life. It also provides guidance about the management of some common
symptoms that may be experienced at the end of life, and places the
individual and their loved ones at the heart of decisions about
their care. The draft NICE guideline follows the abolition of the
Liverpool Care Pathway. The closing date for comments is 9
September 2015.
If you wish to discuss any queries you may have around care
please contact
Stuart Marchant.
Back to top
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
Report on selected summaries of investigations by
the Parliamentary and Health Service Ombudsman: December 2014 and
January 2015. This report contains 121 summaries of complaints
which are a snapshot of those investigated between December 2014
and January 2015 about the NHS in England and UK government
departments and their agencies. It illustrates the impact public
service failures and poor complaint handling in the NHS in England
and UK government departments can have on the public.
Safely home: What happens when people leave hospital and care settings? This report from Healthwatch sets out the findings from its inquiry into people's experiences of the issues surrounding discharge and the impact it has on them when it goes wrong, focusing on older people, homeless people, and people with mental health conditions. Many people said that, although they may have been deemed medically safe to leave hospital, they did not feel safe or adequately supported to do so. Others told the inquiry about experiences of delays to their discharge and the significant consequences of being kept in care too long. The report found that there are five core reasons people feel their departure was not handled properly. It highlights how, when discharge goes wrong, it comes at significant cost, both to individuals and to the health and social care system.
'Learning not blaming': What NHS boards need to
know. Learning not blaming, the Government’s response to three
reports on patient safety, contains several new requirements,
structures and arrangements for NHS boards to be aware of and act
on. They are summarised below and should be considered alongside
announcements made by the health secretary on 16 July to
'profoundly change the culture of the NHS'. The report details the
Department of Health’s response to the Freedom to Speak Up Review
consultation, the Public Administration Select Committee’s report
Investigating clinical incidents in the NHS and Dr Bill Kirkup’s
report on failings in care at Morecambe Bay. It also provides an
update on progress against report recommendations and next
steps.
Powerful people: reinforcing the power of citizens
and communities in health and care. This report argues for
giving citizens greater control over their own h ealth and care, so
that services are redesigned around their needs and aspirations, to
improve health outcomes, and to save money by supporting people
better to manage their conditions themselves.
Code of practice on the prevention and control of
infections and related guidance. The previous code of practice
the prevention and control of infections, and related guidance, has
been updated by the Department of Health to reflect the structural
changes which took effect in the NHS from 1 April 2013. The changes
relate to the role of infection prevention (including cleanliness)
in optimising antimicrobial use and reducing antimicrobial
resistance.
NHS Litigation Authority Annual Report and Accounts
2014/15. In its latest annual report published today, the NHS
Litigation Authority (NHS LA) examines the drivers of the costs of
clinical negligence claims and outlines initiatives to support its
members in their work to improve safety. Figures for the past year
show that the NHS paid out more than £1.1bn to patients and their
legal representatives, and estimates that figure will rise to
£1.4bn over the coming year reflecting the significant increase in
claims that were reported a few years ago. Provisions for future
payments relating to incidents occurring prior to 31 March 2015 are
£28.6bn, an increase of £2.5bn in the year. Approximately one third
of the total sum paid out last year went to the legal profession,
most of which was paid to claimants’ lawyers. The NHS LA has stated
its support for a move to a position where legal costs are more
proportionate to damages whilst ensuring that those with valid
claims have a place to go for skilled and experienced support.
How the NHS in England compares to other countries
in publishing selected transparency metrics. This analysis
looks into how the NHS in England compares to Australia, Canada,
France, Germany, the Netherlands, New Zealand, Norway, Sweden,
Switzerland and the United States in publishing information on
quality of care, patient experience and outcomes.
Older people’s experiences of dignity and nutrition
during hospital stays: secondary data analysis using the adult
inpatient survey. According to this report, an estimated one
million people in later life are affected by poor or inconsistent
standards of dignity or help with eating in hospitals. It calls for
action to improve standards and ensure dignity in care.
7-day NHS services: a factsheet. Hospitals and community services are already working together to create a better service 7 days a week. This fact sheet sets out how the Government wants to go further and faster to deliver safer care in this Parliament.
News
Review to look at the care of new born babies that
need extra support. The CQC is to carry out a thematic review
of about 20 services in England that will look at how well staff in
foetal medicine, obstetrics, neonatal and community services work
together to care for new born babies with declining health
problems, particularly those with hypertension (high blood
pressure) and tracheostomies. It will to use this review to look at
variation in the care management and how one service hands over to
another service so the care is continuous. The review may also lead
to the development of clinical guidelines where required, so there
is consistency in care across England.
If you wish to discuss any clinical risk or health and safety
issues please contact
Joanna Lloyd or
Stuart Marchant.
Back to top
Publications/Guidance
A patient approach: Putting the consumer at the
heart of UK healthcare. This paper from the Institute of
Economic Affairs concludes that the UK has nothing to fear from
adopting market based reforms in healthcare. It finds that
universal and equitable access to healthcare would not be at risk
if the Government’s role were limited to purely guaranteeing access
to health provision. Offering patients the freedom to choose
between public or private providers, as well as building upon the
market reforms of the mid-2000s, would not only be compatible with
public opinion but would substantially improve health outcomes in
the UK. The author Dr Kristian Niemietz argues that supporters of
moving the NHS to a competitive system that incorporates a
combination of public and private providers, should capitalise on
the growing appetite for reform amongst the general public. Going
'the whole hog' would not require a revolution.
CCG Assurance Framework 2015/16: Operating
manual. This operating manual has been developed to complement
the CCG Assurance Framework for 2015/16. It sets
out for CCGs and for staff in NHS England’s regional teams the
details of how the assurance process will operate throughout the
year. It should be used in conjunction with the CCG Delivery
Dashboard technical appendix and other resources provided on NHS
England's CCG Assurance web page.
A fresh start for registration: Improving how we
register providers of all health and adult social care
services. CQC has published information that sets out the
improvements along with its vision for the future of registration
as part of its approach to regulation within a new five-year
strategy from 2016. This document informs people and their families
what they deserve to expect when using health and social care
services registered with CQC. It also explains how CQC's
registration system is there to protect people from poor care by
determining who is able to enter the regulated health and social
care market, or by cancelling or placing conditions on a provider's
registration when required.
Study on the use of contractual mechanisms in commissioning: final report. This report from a three-year project funded by the DH's Policy Research Programme, aimed to investigate how commissioners negotiated, specified, monitored and managed contractual mechanisms to improve services and allocate financial risk in their local health economies, looking at both acute services and community health care. It found that current contracting arrangements are not working and that quality incentive schemes cost more to run than they deliver.
How do I reach a decision about treatment for my patient? A guide for clinicians on decision making in specialised commissioning at NHS England. NHS England has published refreshed guidance and advice for clinicians on accessing treatments in clinically critically urgent situations.
Commissioning for Quality and Innovation (CQUIN) Guidance 2015/16 templates. NHS England has published revised CQUIN templates. Requirements for the community services element of the CQUIN indicator have been clarified for dementia and delirium. For improving physical healthcare, in a revision of the initial guidance, the community early intervention psychosis element of the CQUIN now requires that providers demonstrate progress towards the aims of the CQUIN in community settings through a locally led exercise, with reporting of findings to be assured by locally agreed governance arrangements.
Frequently asked questions and guidance for writing business cases. Following publication of initial guidance on 2 June 2015, Monitor, NHS England and the NHS TDA have provided FAQs on consultancy spending controls/approvals and further guidance to assist trusts and clinical commissioning groups (CCGs) in writing their business cases. The guidance is in two parts: What to cover in a business case and How to ensure your case is as well presented as possible.
Procurement Policy Note 12/15: Availability of
procurement procedures (decision tree). This PPN note contains
a new Decision Tree and guidance on the choice of procurement
procedure resulting from the Public Contracts Regulations 2015. It
also sets out the general policy expectations on procurement that
continue to apply.
Procurement Policy Note 13/15: Increasing the
transparency of contract information. Provides guidance on how
to implement the transparency principles published in March 2015.
It aims to increase the type and accessibility of contract and
procurement data to the public. It applies to all central
government departments including their executive agencies and
NDPBs. it applies to contracts advertised on or after 1 September
2015.
Commissioning and statutory funding arrangements for hospices in England: Survey results 2015. Sets out the findings of a survey by charities Hospice UK and Together for Short Lives of local hospices' experiences of the commissioning and statutory funding environment. It concludes that statutory funding for adult and children’s hospices in England is fragile, unfair and unsustainable. There are early signs that the lack of fair and sustainable funding is already having an adverse effect on hospice services. This could lead to more pressure on already overstretched NHS services if hospices are forced to reduce the level of care they provide. Hospice UK and Together for Short Lives are calling on the Government to set out how it will bring about fair and sustainable statutory funding for hospice and palliative care.
Consultations
Fair and transparent pricing for NHS services: A
consultation on proposals for revising the objection mechanism to
the pricing method. To develop a national tariff, Monitor and
NHS England engage with commissioners and providers of NHS services
and other interested parties. The Health and Social Care Act 2012
specified an objection procedure, which allows commissioners and
providers to object to the chosen method for calculating national
prices, rather than the price itself. If the percentage of
objections meets thresholds set by the Secretary of State, Monitor
cannot adopt and publish the national tariff and must either
reconsider the proposed method and publish a revised tariff for
consideration or refer the method and objections to the Competition
and Markets Authority. This paper seeks views on proposals to
revise the objection process for setting a pricing system for NHS
services in England. The consultation closes on 11 September
2015.
If you wish to discuss the issue of commissioning please contact
David Owens.
Back to top
Publications/Guidance
PFI and the NHS in London: Dealing with the growing
pressure of the Private Finance Initiative on our hospitals in the
capital. This paper from lobbying group NHS Support Federation
examines the scale of PFI debt in London and the extent to which it
influences the financial position of the capital’s NHS trusts. It
looks at some of the impacts on planning and services and how this
affects patients. It explores the options for reducing the burden
of PFI debt in an attempt to move policy makers to taking action
that can help to secure the future of the NHS.
Making payment work better to support new models of
urgent and emergency care: an introduction. This document is
for all organisations involved in the commissioning or delivery of
urgent and emergency care services, including NHS 111, community
pharmacy, community care urgent response and social care urgent
response services, in-hours urgent primary care, GP out-of-hours,
999, ambulance, walk-in centres, urgent care centres, emergency
department attendances and emergency admissions. It is intended for
chief executives, clinicians and others who require a broad
understanding of a potential new payment approach being developed
by Monitor and NHS England to support the service reform, but who
do not need to access detailed guidance on payment design and
implementation.
If you wish to discuss the issue of emergency care please
contact
Claire Bentley.
Back to top
Employment/HR
Publications and Guidance
Contract reform for consultants and doctors and
dentists in training – supporting healthcare services seven days a
week. This report provides the recommendations and observations
of the Review Body on Doctors' and Dentists' Remuneration on the
proposals put forward by the parties for reforming contracts for
both doctors and dentists in training and consultants, to help
deliver the aim of providing healthcare services seven day a
week.
Medical students: professional values and fitness to practice - consultation. The General Medical Council and Medical Schools Council have launched a joint consultation on guidelines to help medical students develop into competent and compassionate doctors that meet the expectations of patients and the public. Two pieces of guidance have been produced which replace the current guidance and aim to help medical students understand the professional values they need to meet while they are at university and also medical schools and universities to deal with concerns about students’ professional conduct and health. The deadline for responses to this consultation is 11 November 2015.
12-hour shifts: prevalence, views and impact. Reports from employers in the NHS appear to suggest that the 12-hour shift system is increasing and may now be the dominant shift system in the NHS. In this document, Steven Weeks, policy manager at NHS Employers summarises the key findings of a major new study that examines the impact 12-hour shifts have on quality of care and patient experience, alongside nurse opinion on the growth of this shift system.
The Royal College of Nursing response to the Nursing and Midwifery Council (NMC) evaluation of the revalidation pilots. The Nursing and Midwifery Council is requiring all nurses and midwives to undergo revalidation every three years, in order to renew their registration. This paper outlines the RCN position on the NMC revalidation pilot. The RCN believes that the right model of NMC revalidation, which is effective and proportionate, can help to protect the public and also to create and sustain a strong culture of professionalism amongst nurses. Their response sets out a number of areas on which the NMC must urgently provide clarity, in order to instil confidence in the nursing workforce and indeed the wider healthcare system that current proposals will be effective, including third party confirmation and the NMC’s emphasis on the use of appraisal as the vehicle for revalidation.
7-day NHS services: a factsheet. Hospitals and community services are already working together to create a better service 7 days a week. This fact sheet sets out how the Government wants to go further and faster to deliver safer care in this Parliament.
Mind the gap - exploring the needs of early career nurses and midwives. This report from Birmingham and Solihull Local Education and Training Council explores staff retention among newly qualified health professionals. It draws conclusions relating to generational differences evident amongst healthcare professionals, and suggests employers need to accommodate generational needs in order to ensure that newly qualified staff of all ages are supported and retained.
Promoting excellence: standards for medical education and
training. This new single set of standards cover both
undergraduate and postgraduate medical education and are designed
to put patient safety, quality of care, and fairness at the heart
of the training received by both medical students and doctors. It
also makes the roles and responsibilities of organisations
delivering medical education clearer as well as the requirements
for teaching, supervision and support. This standard replaces
current GMC standards set out in Tomorrow's Doctors (aimed at
medical students) and The Trainee Doctor (aimed at postgraduate
doctors in training) and comes into effect on 1st January 2016.
GMC
launches new app for doctors. The General Medical Council (GMC)
has launched a new app to help doctors manage their professional
development. The 'GMC My CPD' app enables doctors to record their
ongoing learning activities. The GMC believes it will be a useful
aid to frontline doctors.
All public sector employees who work directly with the public to have fluent English. The Cabinet Office has announced that the Government is to introduce new legislation requiring every public sector worker employed in a public-facing role to speak fluent English. Public sector bodies will have to ensure that staff will have at least ‘level 2’ English, depending on the nature of the role and profession. The legislation and a new code of practice will apply to existing and new employees working in public-facing roles, including police officers, social workers, teaching staff and assistants and local government employees.
Bevan Brittan Updates
Meters
out of reach; legal changes within reach. In a decision which
will have a significant impact on UK equalities law, the European
Court of Justice has answered the question of whether 'associative'
discrimination can apply to indirect discrimination, as well as
direct discrimination. Sarah Maddock reports.
Unpacking Holiday Entitlements. Now that the holiday season is in full swing, we thought it would be timely to provide an update on where we are with holiday entitlements, including the recent decision on holiday pay and long term sick leave.
Employment news round-up - July 2015. This month's news round-up features: trade union reforms, the 'living wage', gender pay reporting, nurse revalidation, tribunal fees, the 'fit for work' service, tax-free childcare, Freedom of Information and details of our forthcoming events. Julian Hoskins reports.
If you wish to discuss any employment issues please contact Julian Hoskins or James Gutteridge.
Finance
Publications and
Guidance
Making change possible: a Transformation Fund for
the NHS. Joint report from the Health Foundation and The King’s
Fund on the key aspects of a Transformation Fund for the NHS in
England. The report draws on analysis conducted by the two
organisations, in particular six case studies of funding
transformation, in the health sector and beyond, along with
examples of local NHS initiatives. They find that the
Transformation Fund requires £1.5–2.1bn a year in dedicated funding
between now and 2020/21. While bringing together the existing
strands will go some way towards this, more resources will be
needed above the £8bn increase in NHS funding already announced by
the Government. The introduction of the Fund would involve two
phases: the first phase (2016/17–2020/21) would be split into two
strands: an Efficiency Strand, which would look to achieve higher
rates of efficiency growth across all services, and a Development
Strand to invest in new models of care. The second phase (2021/22
and beyond) would focus on widespread roll-out of the successful
new models of care. This would include double-running costs
associated with these new models.
Quarterly monitoring report: issue 16. According to this report, more than 60 per cent of NHS trust finance directors think controls on agency spending announced in June will not significantly reduce the amount spent on agency staff. The regular survey carried out for the report also found that three-quarters of trusts intend to recruit more permanent nurses in the next six months, suggesting that the NHS is continuing to prioritise quality of patient care despite rising financial pressures.
Consultations
Public Sector Efficiency Challenge: Chancellor and
Chief Secretary's letter to public sector workers. The
Chancellor George Osborne and Chief Secretary to the Treasury Greg
Hands have written to public sector workers asking for their ideas
on how the Government can do more for less through the Public
Sector Efficiency Challenge. The letter invites them to take part
in an online survey to share their ideas for doing more while
saving public money, ahead of this year’s Spending Review. This
follows a similar exercise in 2010 in which people who were working
on the front line were asked to suggest ways to improve the public
services they provide, using their expertise and knowledge of how
those services are actually delivered. The closing date for
suggestions is 4 September 2015.
News
NHS trusts told financial plans 'unaffordable'. The
BBC reports that the Chief Executive of Monitor, David Bennett, has
written to the 46 foundation trusts with the biggest deficits
"challenging" their financial plans. He has asked all providers ‘to
look at what more can be done’ to reduce the sector’s deficit. The
letter urges FTs to take money-saving measures such as leaving
non-essential vacancies unfilled, and to follow guidelines on safe
staffing in a way which was "proportionate and
appropriate".
If you wish to discuss
any finance issues please contact Claire
Bentley.
Back to top
Information Sharing
Publications/Guidance
Legacy records management: services provided by the
Department of Health Records Office. These documents relate to
services provided by the Department of Health Records Office. They
are for the attention of managers, financial departments and any
other colleagues with records management responsibilities within
organisations that have inherited legacy records from former PCTs
and SHAs.
Information management policy: retention and destruction. This document details the general disposal decisions that the Department of Health applies to information and helps ensure disposal is carried out at the correct time. It is used as a basis for deciding how and when information in all formats is disposed.
Privacy of health records: Europeans' preferences
on electronic health data storage and sharing. This briefing
summaries the evidence from one of the largest-ever surveys of
citizens' views across Europe on security, surveillance and privacy
issues in the storage of health records.
If you wish to
discuss any of the items raised in the above section please
contact Jane Bennett.
Back to top
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
Statutory disclosure guidance. Criminal
disclosure guidance updated to include mental health. The Home
Office has published updated statutory guidance on disclosing
police information within the criminal records process. The first
edition of the guidance was effective from September 2012, with the
updated guidance coming into effect on 10 August 2015. Amid
concerns about the damaging long-term effects on such individuals,
the updated guidance now includes health information, crucially on
when it is relevant and proportionate to disclose mental health
information.
Care and Treatment Reviews: policy and
guidance. Care and Treatment Reviews (CTRs) were developed as
part of NHS England’s commitment to improving the care of people
with learning disabilities or autism. They bring those responsible
for the care of those who are in, or at risk of being admitted to,
specialist hospitals around the table with the individual
themselves and their families, as well as independent clinicians
and experts by experience, to ensure that the care needs of that
individual are being met. This guidance has been produced by
building on the learning from the reviews which have taken place so
far, including extensive engagement with people with learning
disabilities, their representatives and their families. It will
help CCGs and NHS England commissioners implement the
recommendation from this learning that CTRs should become ‘business
as usual’.
Reasons why people with dementia are admitted to a general
hospital in an emergency This study finds the proportion of
people with dementia being admitted to hospital in an emergency
increased by 48 per cent between 2008/09 and 2012/13. It focuses on
the reasons why people with dementia are admitted to a general
hospital in an emergency and considers ways in which some of these
could be prevented. It recommends that although strategies to
improve care for people with dementia have progressed and there is
greater awareness of the symptoms, there is room for
improvement.
Mental healthcare: a capitated approach to payment
with outcomes and risk share components. This document is
intended for all organisations involved in commissioning or
delivering new care models. It is aimed at providers and
commissioners who are interested in more information on
outcomes-based payment models and how they could work in practice.
It will be of particular interest to finance, contracting and
commissioning staff seeking detailed guidance on developing new
financial mechanisms to support service reform.
National Confidential Inquiry into Suicide and
Homicide by People with Mental Illness. The report highlights
areas of healthcare where safety should be strengthened.
Key messages include:
•The rise in suicide among male mental health patients appears to
be greater than in the general population - suicide prevention in
middle aged males should be seen as a suicide prevention
priority.
•It is in the safety of crisis resolution/home treatment that
current bed pressures are being felt – the safe use of these
services should be monitored; providers and commissioners (England)
should review their acute care services.
•Opiates are now the most common substance used in overdose –
clinicians should be aware of the potential risks from
opiate-containing painkillers and patients’ access to these
drugs.
•Families and carers are a vital but under-used resource in mental
health care – with the agreement of service users, closer working
with families would have safety benefits.
•Good physical health care may help reduce risk in mental health
patients – patients’ physical and mental health care needs should
be addressed by mental health teams together with patients’
GPs.
•Sudden death among younger in-patients continues to occur, with no
fall – these deaths should always be investigated; physical health
should be assessed on admission and polypharmacy avoided.
Supporting people with a learning disability and /
or autism who have a mental health condition or display behaviour
that challenges. NHS England, the LGA and ADASS have published
a new draft national framework designed to improve the care of
people with learning disabilities, shifting services away from
hospital care and towards community-based settings. The new draft
service model is the latest piece of work to emerge from the
Transforming Care for People with Learning Disabilities
programme.
Dementia: Statistics on prevalence and improving
diagnosis, care and research. This Commons research note
outlines Government, NHS and other statutory bodies’ work to
improve dementia diagnosis, care and support and research. It also
includes statistics, tables and maps on age-adjusted dementia
prevalence across the UK, including for each English Parliamentary
constituency.
Dementia friendly communities – Guidance for
councils. Discusses the important role of councils in
supporting people with dementia by creating local dementia friendly
communities. It includes case studies that demonstrate how many
councils are already working in partnership with their local
communities to develop innovative ways to enable people with
dementia to take part in everyday activities and retain their
independence for as long as they are able.
Finding a path for the cure for dementia: an
independent report into an integrated approach to dementia
research. This report by Raj Long, Senior Regulatory Officer at
the Bill & Melinda Gates Foundation, sets out what and where
hurdles exist in the development of treatments for dementia. The
report forms part of the ambition to help drive towards the G8
dementia summit’s goal of a cure or disease modifying therapy for
dementia by 2025.
Consultations
Supporting people with a learning disability and/or
autism who have a mental health condition or display behaviour that
challenges. NHS England, the LGA and the Association of
Directors of Adult Social Services have published a new draft
national framework designed to improve the care of people with
learning disabilities, shifting services away from hospital care
and towards community-based settings. The draft Service Model sets
out nine overarching principles which define what 'good' services
for people with learning disabilities and/or autism whose behaviour
challenges should look like. The closing date for comments is 4
September 2015.
Cases
Re MOD and others (Deprivation of Liberty) [2015] EWCOP
47. The Court of Protection considered several cases before it
in the light of guidance from the Supreme Court and Court of Appeal
on the subject of deprivation of liberty in the context of Sch.1A
to the Mental Capacity Act 2005 which contained a scheme whereby a
managing authority of a hospital or care home was allowed to
deprive a patient or resident of his or her liberty. See case
summary by Hannah Taylor on the mental health extranet.
Bevan Brittan Updates
Mental
Capacity and Deprivation of Liberty. On 7 July 2015 the Law
Commission published its Consultation Paper on Mental Capacity and
Deprivation of Liberty. In this alert we explain the key proposals
put forward.
Bevan Brittan Events
At the beginning of November, Bevan Brittan's Court of Protection
team is hosting a practical update session which will cover
relevant legislation, guidance and case law and their impact on
managing cases involving incapable patients. If you would like to
register your interest in any of these sessions please click
on any of the links below:-
Court of Protection - Birmingham
Court of Protection - Bristol
Court of Protection - London
If you wish to discuss any of the items raised in
the above section please contact
Simon Lindsay or
Stuart Marchant.
Back to top
Primary Care
Publications/Guidance
Primary care in the NHS: Busting the myths. The
NHS Confederation is publishing a series of myth busters, which
challenge common misconceptions and enrich debate on topical,
sometimes controversial, issues regarding our health and care. This
one, the third in the series, dispels myths about primary care in
the NHS. Previous myth busters covered Competition in the NHS and NHS managers.
Primary care co-commissioning submission and
approval process. NHS England has set out the key dates and the
application process for CCGs who wish to apply in 2015/16 to take
on new delegated and joint commissioning arrangements for the
majority of GP services. CCGs are encouraged to work closely with
their regional directors of commissioning operations and teams as
soon as possible in advance of making applications. For delegated
commissioning arrangements, CCGs should submit their proposal by
the extended deadline of noon on 6 November 2015 to england.co-commissioning@nhs.net
and their local NHS England team. CCGs who meet the criteria will
take on delegated arrangements from 1 April 2016. For joint
commissioning arrangements, CCGs are able to go live on the first
day of each quarter, before which submissions should be made and
shared with local NHS England teams. The next implementation date
for joint commissioning is 1 October 2015.
The future of primary care: Creating teams for
tomorrow. The independent Primary Care Workforce Commission,
chaired by Martin Roland CBE, was commissioned by the DH and Health
Education England to identify and highlight innovative models of
primary care that will meet the future needs of patients and the
NHS. Its report calls for greater collaboration across
organisations and a broader range of staff involved in the delivery
of healthcare. Back to top
Improving acute inpatient psychiatric care for
adults in England: interim report. The Commission on Acute
Adult Psychiatric Care was set up by the Royal College of
Psychiatrists in response to widespread concerns about the
provision of acute inpatient psychiatric beds and alternatives to
admission available for patients. This interim report is based on
the Commission’s initial observations about acute inpatient
psychiatric services for adults in England and its discussions with
patients, carers, advocates, health and social care professionals
and policy makers. It finds that the so-called bed or admission
crisis in adult mental health is very significantly a problem of
discharges and alternatives to admission that can only be addressed
through changes in services and management of the whole
service.
Examples of outstanding practice. The CQC has
been inspecting general practices under a new inspection model
since October 2014, and has now published approximately 1,200 GP
practice inspection reports. This online tool brings together a
collection of some of the most innovative and effective examples of
outstanding practice that CQC inspectors have found since
implementing the new methodology.
If you wish to discuss any queries you may have around primary care
please contact
David Owens.
Public Health
Publications/Guidance
E-cigarettes: an evidence update. PHE has
published a review that explains the relative risks and benefits of
e-cigarettes, in terms of harm reduction when compared with
cigarettes and as an aid to quitting. The review concludes that
e-cigarettes are significantly less harmful to health than tobacco
and have the potential to help smokers quit smoking.
Doing, supporting and using public health research:
the Public Health England strategy for research, translation and
innovation This document sets out PHE’s commitment to research,
translation and innovation; the steps that PHE will take, alone or
with partners, to do research, to support research and to use
evidence from research.
Inequalities in life expectancy: Changes over time
and implications for policy. This report from the King's Fund
explores how the relationship between income deprivation and life
expectancy (the "Marmot curve") has changed over time and looks at
the impact of other variables such as employment, housing
deprivation, binge drinking and diet. It assesses what that tells
us about the success or otherwise of government policy on
inequalities in health over the period 1999–2003 to 2006–10.
Smoking in vehicles. The DH has issued an
update on the new law on smoking in cars and other vehicles with
someone under 18, that comes into effect on 1 October 2015.
Who we are and what we do: Annual Plan 2015/16.
PHE has published its latest Annual Plan that sets out its core
functions and outlines the key steps and actions for the year
ahead.
Review of the Public Health Skills and Knowledge
Framework (PHSKF). This report presents the outcomes of the
first stage of the review of the UK PHSKF that sets out the skills
and knowledge that the public health workforce need for their
current and future practice.
NHS public health functions agreement: Variation to
the 2014-15 agreement on public health functions to be exercised by
NHS England. Provides for variations to the NHS public health
functions agreement that 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).
Royal Society for Public Health: Rethinking the
public health workforce. This report outlines plans for a range
of different occupations to support efforts to improve the public’s
health. It identifies a number of occupations, who have already
started to support public health work, many of which already have
regular contact with the public, such as the fire service, allied
health professionals and pharmacists. With only 40,000 people
estimated to be part of the core public health workforce, and in
light of the crisis in lifestyle health issues, the report calls
for anyone who has "the opportunity or ability to positively impact
health and wellbeing through their work" to join the wider public
health workforce.
Consultations
Consultation guide: National procurement for the
provision of behavioural interventions for people with non-diabetic
hyperglycaemia. NHS England, Public Health England and Diabetes
UK are asking CCGs to register their interest in becoming first
wave sites for the NHS diabetes prevention programme in 2016. The
programme will focus on improving diet, weight and exercise to
reduce the incidence of type 2 diabetes. Service providers will
also be invited to contribute to the programme. The deadline for
responses is 7 September 2015. The feedback will be used to help
NHS England develop an Invitation to Tender (ITT) later this
year.
Community engagement: approaches to improve health
and reduce health inequalities. NICE has issued a draft public
health guideline on approaches to community engagement to help
communities improve their health and wellbeing and reduce health
inequalities. The closing date for comments is 24 September
2015.
If you wish to discuss any queries you may have around public
health please contact Olwen
Dutton.
Publications/Guidance
Capacity and capability to regulate the quality and
safety of health and adult social care. This report finds that
the Care Quality Commission has made substantial progress as it
seeks to address public concerns about its regulatory approach, but
argues that significant challenges lie ahead if it is to
demonstrate effectiveness and value for money.
Rethinking regulation. According to a report from the Professional Standards Authority (PSA), the healthcare regulatory framework in the UK is out of date, over-complicated and too expensive. In the report ‘Rethinking regulation’ the PSA concluded the nine organisations which regulate health professionals and social workers in the UK are largely ineffective and are becoming unfit to meet future challenges.
CQC annual report 2014/15. Reflects on how CQC
has progressed from designing, testing and evaluating its new,
rigorous and expert-led way of monitoring, inspecting and
regulating health and adult social care services across England, to
implementing it. it includes details of its achievements in
2014/15. Back to top
If you wish to discuss any queries you may have around regulation
please contact
Stuart Marchant.
General
Publications/Guidance
The Health and Social Care Act 2008: Code of
Practice on the prevention and control of infections and related
guidance. This revised version of the CoP replaces the edition
published in 2010 and applies to NHS bodies and providers of
independent healthcare and adult social care in England, including
primary dental care, independent sector ambulance providers and
primary medical care providers. The code now reflects the changes
required to meet the Health and Social Care Act 2008 (Regulated
Activities) Regulations 2014 and the role of infection prevention
(including cleanliness) in optimising antimicrobial use and
reducing antimicrobial resistance. The law states that the code
must be taken into account by the CQC when it makes decisions about
registration and that providers must have regard to the code when
deciding how they will meet the regulations. However, the code is
not mandatory, so registered providers do not by law have to comply
with the code. A registered provider may be able to demonstrate
that it meets the regulations in a different way (equivalent or
better) from that described in this document.
Complete list of NHS estates related guidance. The DH has published a spreadsheet that is a definitive list of all estates related guidance past and present. It identifies the current status of each document, including whether it has been superseded and whether it is available for download. It includes health building notes (HBN), health technical memorandum (HTM) and choice framework for local policies and procedures (CFPP).
Report of the Chief Coroner to the Lord Chancellor
– Second Annual Report 2014 to 2015. This is the Chief
Coroner's second annual summary of the operation of coroner
services under s.36 of the Coroners and Justice Act 2009, following
the implementation of the Act’s reforms in July 2013. The report
summarises his work to promote consistency in the resourcing of and
practices in coroner offices across England and Wales. It
highlights how the Chief Coroner is working towards a greater
consistency in all areas of the coroner domain and is encouraging
bringing coroner services together under one roof.
Better leadership for tomorrow: NHS leadership
review. The Secretary of State for Health asked Lord Rose to
conduct a review into leadership in the NHS. The review asked what
might be done to attract and develop talent from inside and outside
the health sector into leading positions in the NHS. It also asked
how strong leadership in hospital trusts might help transform the
way things get done and how best to equip CCGs to deliver the NHS
five year forward view. It makes 19 recommendations covering
training, performance management, bureaucracy and management
support.
News
'Common sense' plea over ambulance speeding fines. The
BBC reports that ambulance trusts spent hundreds of hours having to
appeal against speeding fines issued to emergency vehicles by
police forces. Health bosses have called for the automatic
exemption on emergency vehicles to be better enforced. Some trust
staff are spending 40 hours a month appealing against the fines.
The web page includes statistics on penalty charge notices issued
to ambulance trusts.
