30/09/2015
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
Publications
Mental Capacity Act 2005, Deprivation of Liberty
Safeguards (England), Annual Report 2014-15. This official
statistics report provides the findings from the Mental Capacity
Act 2005, Deprivation of Liberty Safeguards (DoLS) data collection
for the period 1 April 2014 to 31 March 2015. Also see Care Management Matters news
report.
Care and support: What's changing? Updated information on what the changes to the Care and Support Act mean for carers and the cared for.
Ambitions for palliative and end of life care: A national framework for local action 2015-2020. The National Palliative and End of Life Care Partnership, made up of statutory bodies including NHS England, the Association of Adult Social Services, charities and groups representing patients and professionals has developed a framework for action in making palliative and end of life care a priority at local level. It builds on the DH’s 2008 Strategy for End of Life Care and responds to an increased emphasis on local decision making in the delivery of palliative and end of life care services since the introduction of the Health and Social Care Act 2012.
Counting the cost of care – The council’s role in
informing public choices about care homes. This LGO focus
report examines whether families across England are paying more
than they need to because they have not been given comprehensive
information about the costs of care available in their area. It
provides guidance for councils to make sure their procedures do not
put people at risk of paying too much and offers questions for
councillors to help scrutinise their authorities’ policies and
procedures. The report includes examples of cases where councils
provide confusing or incorrect advice, do not offer potential
residents a genuine choice of affordable care home or have any
affordable homes available.
An analysis of social care activity in prisons and
approved premises. The Care Act 2014 "clarified" local
authority responsibilities for people living in prisons and
approved premises. This ADASS report describes what happened in the
first three months from when the legislation was implemented in
April 2015. it sets out the findings of a survey of all local
authorities in England with either a prison or approved
premises.
Home
care: delivering personal care and practical support to older
people living in their own homes. This NICE guideline covers
the planning and delivery of person-centred care for older people
living in their own homes (home care or domiciliary care). It aims
to promote older people's independence and to ensure safe and
consistently high quality home care services. It recommends that
services support the aspirations, goals and priorities of each
person, and that they and their carers are treated with empathy,
courtesy and respect. Home care visits shorter than half an hour
should only be made if the home care worker is known to the person
and the visit is part of a wider package of support and the purpose
of the visit can be properly undertaken in that time. The guideline
also highlights the importance of prioritising continuity of care
by ensuring the person has the same home care worker or workers so
that they can become familiar and build a relationship.
A charge on caring? This report from the Carers
Trust analyses the use and impact of charges by councils providing
support to unpaid carers. Following concerns that a number of local
authorities had started to introduce charges to unpaid carers for
the support they provide to help them in their caring role,
contrary to the Care Act statutory guidance, the Trust sent an FOI
request to all social services councils in England to establish how
many councils are using charges, how are they are being applied,
and the impact they are having on carers.
Moving care closer to home. Monitor has
published resources that provide support for providers and
commissioners to make evidence-based appraisals of how the benefits
compare with the costs of various approaches to move care closer to
home.
Revised Prevent duty guidance. Updated guidance
under the Counter-Terrorism and Security Act 2015 to authorities
(including health organisations) on the duty to have due regard to
the need to prevent people from being drawn into terrorism – the
"Prevent duty".
News
Nice criticises ‘flying home care visits’ as short
as five minutes. Government advisers want care workers to spend
at least half an hour with vulnerable people but admits council
budget cuts are an obstacle.
Journal Articles
Stuart Marchant and Emma Timmons have published an article in Care
Management Matters called Deprivation of Liberty - your chance to change the
law.
If you wish to discuss any queries you may have around care
please contact
Stuart Marchant.
Back to top
Children/young
people
Consultations
Continuing care for children and young people with
complex needs. The DH is seeking views on the revised National
Framework for Children and Young People’s Continuing Care,
including a tool to ensure all relevant needs are assessed and
support decisions about care. The framework helps CCGs and other
professionals to assess the care required for children and young
people with health needs that are not met by existing or
specialised services. The 2010 framework has been revised to take
account of changes to commissioning and the new arrangements for
children with special educational needs and disability. The
consultation closes on 23 October 2015.
Jointly commissioning palliative care for children and young people. Children’s palliative care charity Together for Short Lives has published a guide to support CCGs and local authorities in England to commission palliative care for children and young people aged 0–25 effectively. It also supports health and wellbeing boards to understand their role in the commissioning process.
If you wish to discuss any issues relating to foundation trusts please contact Claire Bentley.
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/
The National Safety Standards for Invasive Procedures
(NatSSIPs) aim to reduce the number of patient safety incidents
related to invasive procedures in which surgical Never Events could
occur. These new standards set out broad principles of safe
practice and advise healthcare professionals on how they can
implement best practice, such as through a series of standardised
safety checks and education and training. The standards also
support NHS providers to work with staff to develop and maintain
their own, more detailed, local standards and encourage the sharing
of best practice between organisations.
Complaints about acute trusts 2014-15. This
report outlines how many unresolved complaints the Parliamentary
and Health Service Ombudsman (PHSO) investigated for every acute
trust in England and the final decision made. It reveals that,
similar to last year, the top three reasons for hospital complaints
investigated by the PHSO in the last financial year were poor
communication, errors in diagnosis and poor treatment. Non-medical
aspects of patient care are cited as a factor in almost half of all
complaints investigated, while poor communication, including
quality and accuracy of information, was a factor in one third of
all complaints. Other reasons for complaints in this period
included staff attitude and behaviour, which were factors in two
out of 10 complaints. See
also BBC news
NHS whistleblowing procedures in England. This
Commons Library research briefing sets out the current rights and
procedures for NHS staff to raise concerns about safety,
malpractice or wrongdoing at work ("whistleblowing").
Consultations
Independent Patient Safety Investigation Service
Expert Advisory Group – Call for evidence. The new Independent
Patient Safety Investigations Service (IPSIS), which will operate
from April 2016, will offer support and guidance to NHS
organisations on investigations into serious patient safety
incidents, and carry out certain investigations itself. An Expert
Advisory Group has been set up to make recommendations on how the
new investigation service should work, and is seeking views from a
wide range of stakeholders. The closing date for comments is 31
October 2015.
See also an article by Dr Mike Durkin, Director of Patient
Safety, NHS England, in which he discusses the plans for IPSIS.
NHS maternity review. The NHS maternity review
is currently underway to make recommendations for the improvement
of services for women and their families. It is open to women,
fathers, partners, their families and advocates, professionals,
commissioners and people from representative organisations. The
closing date for comments is 31 October 2015.
Independent Patient Safety Investigation Service
(IPSIS) expert advisory group: call for evidence. The
Independent Patient Safety Investigations Service, which will
operate from April 2016, will offer support and guidance to NHS
organisations on investigations into serious patient safety
incidents, and carry out certain investigations itself. An expert
advisory group has been set up to make recommendations on how the
new investigation service should work, and is seeking views from a
wide range of stakeholder. It wants views on 5 related themes:
independence, governance and accountability; engagement and
transparency; what IPSIS should investigate; supporting improvement
and learning; and people, skills, operation. The deadline for
responses to this consultation is 31 October 2015.
News
Silicone implants withdrawn due to contamination
fears. Implants used in thousands of operations have been
withdrawn in Britain by the Medicines and Healthcare products
Regulatory Agency (MHRA) following the suspension of the CE
certificate of conformity for all devices made by Brazilian
manufacturer Silimed. An inspection of the manufacturing plant
found that some devices were contaminated with particles. The
implants have been used in procedures including breast implants,
calf implants and gastric band surgery. A medical device cannot be
marketed in Europe without carrying a CE mark. The MHRA said an
urgent investigation is being carried out to discover what the
particles are and whether they would pose a threat to safety.
Cutting reliance on paper will make patients safer,
says NHS England. The NHS will urge health and social care
leaders to end the unnecessary reliance on paper in the treatment
of patients and make services safer, more effective and
efficient.
EMA begins medical literature monitoring
service. The European Medicines Agency (EMA) has started its
full medical literature monitoring service which it expects will
improve the safety monitoring of medicines. It is intended to
benefit around 4,000 pharmaceutical companies, with a total of 400
active substance groups will now be monitored under the new
programme.
Clinical negligence lawyers warn of "rushed"
pre-Christmas consultation on fixed fees. The Department of
Health is planning a "rushed" pre-Christmas consultation on fixed
fees, according to medical negligence lawyers including Rosamund
Rhodes-Kemp, vice-chair of the Society of Clinical Injury Lawyers,
who said she was concerned the consultation would be run for only
six weeks between mid-November and the end of the year.
Insurer invokes ‘fundamental dishonesty’ to see off
claims. Insurer Axa has forced two claimants to revoke GBP
25,000 personal injury claims after invoking the fundamental
dishonesty defence introduced under the Criminal Justice and Courts
Act 2015. It is believed to be one of the first-known occasions
that an insurer has used powers under the Act to have a claim
thrown out in total if it is proven the claimant was fundamentally
dishonest.
NHS Maternity Review. NHS England is seeking
views on improving maternity services. Responses will feed into the
Maternity Review that will assess current maternity care provision
and consider how services should be developed to meet the changing
needs of women and babies. The consultation closes on 31 October
2015.
NHS warns nurse immigration rules 'harm patient safety'.
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
Investigation into NEW Devon CCG’s commissioning of
community services for adults with complex care needs in eastern
Devon: final report. Monitor has published the findings of its
investigation into how Northern, Eastern and Western Devon CCG (NEW
Devon) selected Royal Devon and Exeter NHS Foundation Trust as its
preferred provider of community services for adults with complex
care needs in east Devon. Monitor opened its investigation after
receiving a complaint from Northern Devon Healthcare NHS Trust, the
current contract holder, which claimed that NEW Devon had
undertaken an inadequate and unfair process in awarding a contract
for these services. Monitor found that NEW Devon's commissioning of
community services did not breach NHS commissioning regulations;
however, the CCG will be doing further work in the next phase of
its process as a result of the investigation. The commissioner took
into account patient needs and the service improvements required
and designed a process to select a provider from a number of
proposals. However, the CCG now needs to do more work to ensure
that it will get value for money before awarding the contract.
Transforming healthcare in England’s core cities. NHS Clinical Commissioners has launched a new publication showing how CCGs in England’s Core Cities are taking up the challenge set out in the Five Year Forward View and transforming the way in which healthcare is delivered to the benefit of their local population. The report's key themes are: developing new partnerships; ensuring equity of care across diverse populations; improving wellbeing; and finding better ways to provide healthcare services.
CCG involvement and the NHS Commissioning Assembly. NHS England and NHS Clinical Commissioners have released a joint note detailing how NHS England will engage with CCGs going forward. This follows NHS England's announcement last month that the Commissioning Assembly had been disbanded.
Managing conflicts of interest in NHS clinical commissioning groups. The National Audit Office has published its findings following an investigation into managing conflicts of interest in NHS clinical commissioning groups (CCGs). Among the key findings is that, across different CCGs, the adequacy of controls for managing risks of conflicts of interest varies.
If you wish to discuss the issue of commissioning please contact David Owens.
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Emergency CarePublications/Guidance
A&E delays: why did patients wait longer last
winter? In quarter three 2014/15, the performance of A&E
departments against the four hour standard reached its lowest in
ten years. This report shows that the target four hour emergency
care indicator is a measure of the performance of the whole health
and care system, not just emergency care departments; the findings
show that across England the rest of the hospital struggled to cope
with the increase in admissions because of very high occupancy
rates.
Investigating the impact of out-of-hours GP services on A&E attendance rates: multilevel regression analysis. This paper sets out how the NAO used an analytical technique called multilevel regression modelling to investigate the factors affecting levels of attendance at accident and emergency (A&E) departments by patients registered at a GP practice.
If you wish to discuss the issue of emergency care please contact Claire Bentley.
Employment/HR
Publications and Guidance
Nursing agency rules. This guidance outlines
the new rules on nursing agency spend from Monitor and the NHS
Trust Development Authority for NHS foundation trusts and NHS
trusts. The rules come into effect on 1 September 2015 and apply to
agency spend on registered nursing, midwifery and health visiting
staff only. They include:
an annual ceiling for total agency
spend for each trust between 2015/16 and 2018/19;
trusts are being sent individual
ceilings today and will have the opportunity to apply for
exceptions if there are specific local needs;
mandatory use of frameworks for
procuring agency staff; and
limits on the amount individual
agency staff can be paid per shift, which will be implemented later
in the year after further work by the two organisations.
NHS whistleblowing procedures in England. This Commons Library research briefing sets out the current rights and procedures for NHS staff to raise concerns about safety, malpractice or wrongdoing at work ("whistleblowing").
Junior and consultant contract negotiations. In July the Review Body on Doctors' and Dentists' Remuneration (DDRB) published its recommendations and observations on the proposals put forward by the parties for reforming contracts for both doctors and dentists in training and consultants. This document contains a detailed analysis by the BMA on what the proposals mean for junior doctors.
Contracts and conditions in the NHS. This Commons Library briefing paper contains press coverage, parliamentary material, reports and Library briefings relevant to the Westminster Hall debate on Contracts and conditions in the NHS, that was scheduled for 14 September 2015. The debate was triggered by an e-petition which called for Parliament "To debate a vote of no confidence in Health Secretary the Right Hon Jeremy Hunt".
Seven day services: an evidence base of enablers for transformation. NHS Improving Quality Seven Day Services team have been leading a service improvement programme across England designed to support the transformational change required to deliver access to high quality health and social care every day of the week. They interviewed key representatives of health and social care communities, from across the country, to determine what have been the key enablers and barriers in delivering change. The initial findings can be found in this report.
News
Simon Stevens announces major drive to improve
health in NHS workplace. The NHS England Chief Executive Simon
Stevens has launched a major drive to improve the health and
wellbeing of 1.3m health service staff, in a bid to benefit both
staff and taxpayers. Speaking at the NHS Innovation Expo
conference, Mr Stevens set out how NHS organisations will be
supported to help their staff to stay well, including serving
healthier food, promoting physical activity, reducing stress, and
providing health checks covering mental health and musculoskeletal
problems – the two biggest causes of sickness absence across the
NHS.
Hospitals warned by CQC over staff shortages. Three in four NHS hospitals have been warned by the Care Quality Commission (CQC) about potentially dangerous staff shortages in key areas, including critical care. However, a crackdown on health spending is putting hospitals under intense pressure to cut staffing costs to avoid going into debt.
A National Guardian for the NHS - Have your say. The CQC is seeking views on the new role of National Guardian, created to support whistleblowers in the NHS and improve reporting culture. The paper sets out its plans for how the National Guardian will operate, its scope and the specific functions it will cover. The consultation closes on 9 December 2015.
NHS warns nurse immigration rules 'harm patient safety'.
Bevan Brittan Articles
Travel time included in "working time" In an important decision
for any organisation whose workers are based at home but travel to
carry out their work – such as community nurses who drive from
their homes to see patients, or maintenance staff who travel to
various sites to carry out repairs – the European Court of Justice
(ECJ) has today handed down its full judgment in the case of
Federación de Servicios Privados del Sindicato Comisiones Obreras v
Tyco Integrated Security SL.
Travel to work can be 'work'. Sarah Lamont follows up on our recent Alert on Tyco Integrated Services, and resolves some of the potential confusion over the practical and cost implications of the decision that travel time can count as 'work' for mobile workers.
Substantial influence by HR can lead to unfair dismissal James Gutteridge explains recent and important guidance on the scope of HR's role in disciplinary investigations.
If you wish to discuss any
employment issues please contact Julian
Hoskins or
James Gutteridge.
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Finance
Publications/guidance
The health of health finances. This CIPFA paper
considers whether the Government has adequate plans to deal with
the financial pressures on the health service. It looks at recent
financial results and forecasts and the pressures they indicate,
making comparisons with trends in spending levels and analysing the
specific pressures likely in future years. Current plans are based
on the NHS’s Five Year Forward View’s assessment that £30bn of
pressures are faced over the five years to 2021, and that £8bn of
that will be offset by additional funding. CIPFA concludes that the
key figures of £30bn pressures and £22bn savings are both
optimistic, and – ahead of the forthcoming Comprehensive Spending
Review – makes recommendations for how the Government can improve
the realism of the plans, and what actions it should take to make
any plan a more deliverable reality.
The financial cost of healthcare fraud report 2015. This report contains an in depth section on the UK's NHS showing what the NHS's own figures indicate the cost of fraud to be in each main area of expenditure – payroll, procurement, GP, dental, optical, and pharmaceutical services, as well as losses to income from patient charges. There are also examples of types of fraud.
Spending Review submission: health and social care
funding – The short, medium and long-term outlook. The King's
Fund's submission to the Government for the November 2015 Spending
review argues that the period covered by this Spending Review will
be the most challenging in the recent history of the health and
social care system. Both services must simultaneously respond to
growing pressures on services and put in place large-scale changes
to ensure their future sustainability. Failure to do so will mean
patients having to wait longer for diagnosis and treatment, the
quality of health and social care declining, and fewer people
receiving publicly funded social care. It concludes that it is not
credible to maintain that current standards of care can be
sustained (let alone improved) without the funding needed to
deliver this. The Government should therefore spell out the
consequences for patients and users of publicly funded social care
of not providing the additional funding we argue for. This means
being honest about the fact that access to care will deteriorate
further and quality of care will be compromised because of the
choices made about public spending and taxation during this
Parliament.
2015 Comprehensive Spending Review: Representation
to HM Treasury. The Nuffield Trust’s representation looks at
the pressures on NHS funding up to 2020, the scope for savings and
efficiencies, and the difficult choices on funding facing
policymakers. Its briefing looks at the £8bn in extra funding
promised to the NHS by 2020. It concludes that while it is a
generous settlement in the context of wider spending cuts, it will
be outpaced by constantly rising health care costs and patient
numbers, with a real struggle to maintain standards. It expresses
concern that other budgets held by the Department of Health may not
be ring-fenced. Giving the NHS more money by cutting services it
relies on, like training and public health, would be
counterproductive; equally, the funding squeeze on social care
could put progress on prevention and co-ordinated care at
risk.
News
King's Fund Toolkit - Pilot sites announced!!
The King's Fund has announced the 24 pilot sites that will test a
“close partnering” toolkit which promises to improve relationships
between clinical staff and finance teams. Nurses and midwives in
the pilot sites are encouraged to actively engage and test the
toolkit.
NHS approves hospital chains. The NHS has approved the creation of chains of hospitals for the first time in its history in the hope of alleviating deep financial problems and allowing more patients to receive care from leading doctors in their fields.
If you wish to discuss any issues relating to
foundation trusts please contact
Claire Bentley.
Back to top
Foundation Trusts
Publications/guidance
Foundation trust and NHS trust mergers. Mergers
of trusts in the NHS are often instigated by national bodies so
that NHS trusts can gain foundation trust status or failing
providers can be rescued from financial difficulties. This report
looks at 20 mergers between 2010 and mid-2015 and finds that
significant sums of money are being spent on such mergers (£2
billion on just 12 mergers over this period), often based on faulty
argumentation and a lack of evidence that mergers offer lasting
solutions. It concludes that the Department of Health, Monitor and
the Trust Development Authority should support service improvement
and transformation where possible, rather than instigate merger. If
a merger is contemplated, there needs to be a more realistic
assessment of the costs and benefits.
If you wish to discuss any issues relating to
foundation trusts please contact
Vincent Buscemi. Back to top
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
Accessing and sharing health records and patient
confidentiality. This House of Commons Library briefing note
sets out current arrangements for accessing patient records and
sharing confidential patient information. it describes how patients
may request access to their records and the circumstances in which
access to the records of others may be allowed and outlines
safeguarding arrangements for confidential patient information. It
also describes statutory and public interest disclosures of patient
information, information sharing rules for people who lack mental
capacity and access to information on hereditary conditions for
relatives.
News
HIV clinic reveals patients' identities in data
breach. An enquiry is to be launched after an HIV clinic in
London, the 56 Dean Street clinic, sent out a newsletter which
disclosed names and email addresses of 780 people, many of whom are
HIV patients. Health Secretary Jeremy Hunt has ordered the inquiry
into how the NHS handles confidential medical information.
Researchers warn that health apps could be privacy risk. Researchers from Imperial College London and the Imperial and Ecole Polytechnique CNRS France have warned that NHS-accredited health apps, which send unencrypted personal and health information over the internet, could be putting users' privacy at risk.
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
Mental Capacity Act 2005, Deprivation of Liberty
Safeguards (England), Annual Report 2014-15. This official
statistics report provides the findings from the Mental Capacity
Act 2005, Deprivation of Liberty Safeguards (DoLS) data collection
for the period 1 April 2014 to 31 March 2015. Also see Care Management Matters news
report.
The five year forward view mental health taskforce: public engagement findings. This report summarises the views of more than 20,000 people on the top priorities for reshaping mental health services, as part of a drive to develop a five year national NHS strategy for people of all ages. Better access to high quality services, a wider choice of treatments, more focus on prevention, more funding and less stigma were the top five calls for change by 2020.
Horizon scanning: The legislative landscape in
mental health. Mental health care and services are delivered
within a complex legislative framework. There have been changes to
this framework in the last 12 months with more revisions proposed.
This briefing aims to provide members with an overview of the
current legislative landscape, highlight how the current
legislation is working in practice and explore the potential impact
of proposed changes.
Inquiry: mental health and wellbeing of looked
after children. Building on the Health Committee’s recent
report on children's and adolescents' mental health and CAMHS, the
Education Committee has announced an inquiry into the mental health
and wellbeing of looked after children. The deadline for receipt of
written submissions is 29 October 2015.
You are not alone: Help is at Hand for anyone
bereaved by suicide. A guide for people affected by suicide and
written by those directly affected has been published by Public
Health England (PHE) and the National Suicide Prevention Alliance
(NSPA).
Peer support for people with dementia – A social
return on investment (SROI) study. This report from the Health
Innovation Network finds that peer support groups, or having the
opportunity to meet others regularly, can help people with dementia
feel less lonely and less isolated and are a valuable intervention.
Dementia peer support groups also offer carers respite by providing
some time for themselves, and the opportunity to meet other carers.
It provides benchmark evidence for those looking to commission,
invest or set up dementia peer support groups and will be useful
for organisations and groups providing peer support services when
applying for funding.
Identifying and responding to suicide clusters and
contagion: a practice resource. This toolkit, based on research
of suicide clusters, is part of PHE's support for the government’s
suicide prevention strategy. It is aimed at people with
responsibility for suicide prevention in local authorities and
their partner agencies. The steps required at local level to
prepare for a suicide cluster are described alongside suggested
responses to possible suicide clusters. Finally, best practice is
provided on how to evaluate responses to a cluster, and on using
the experience to improve further suicide prevention measures.
Section 49 reports – the thorny issues. This is a cross-post to the Court of Protection Handbook site, where Alex Ruck- Keene has just written about the very recent decision in Re RS on s.49 reports.
Journal Articles
Stuart Marchant and Emma Timmons have published an article in Care
Management Matters called Deprivation of Liberty - your chance to change the
law.
News
DoLS applications increase tenfold in a year.
The Health and Social Care Information Centre (HSCIC) has published
its statistics report on the findings from the Mental Capacity Act
2005, Deprivation of Liberty Safeguards (DoLS) data collection for
the period 1st April 2014 to 31st March 2015. It includes any
application that was received and/or completed during the reporting
year.
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
Clinical pharmacists in general practice pilot
FAQs. NHS England is asking CCGs to share further guidance on
the application process for the clinical pharmacists in general
practice pilot. GP practices must submit their application for the
scheme by 17 September 2015. Applicants should read these
guidelines on how to register for access to the SharePoint website
and to view further supporting information.
News
More than one in 10 GP roles in England vacant.
A survey by the RCGP has found that more than one in 10 family
doctor roles in England are vacant, with many practices
increasingly having to rely on locum doctors to deliver patient
care. The survey of 549 practices in England found that 10.2% of
full time equivalent positions are vacant, with 61% of these
currently filled by locum or agency staff. Of the practices
surveyed, 64% reported that finding enough locum doctors to meet
growing patient demand was either difficult or very difficult; just
8% reported that this was easy. The findings also cast doubt on the
feasibility of government plans to introduce a seven-day working
week in general practice, which would involve stretching current
resources even further.
If you wish to discuss any queries you may have around primary
care please contact
David Owens.
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Public Health
Publications/Guidance
Reviewing the indicators in the Public Health
Outcome Framework. The Public Health Outcomes Framework sets
out a high-level overview of public health outcomes, at national
and local level, supported by a broad set of indicators. The
indicators cover the full spectrum of what is understood as public
health and what can be measured at the moment. This consultation
seeks views on whether government should remove, replace or revise
the existing indicators in the framework. The closing date for
comments is 2 October 2015.
Identifying and responding to suicide clusters and contagion: a practice resource. Guidance for people with responsibility for suicide prevention in local authorities and their partner agencies. It sets out the steps required at local level to prepare for a suicide cluster, alongside suggested responses to possible suicide clusters. It provides best practice on how to evaluate responses to a cluster, and on using the experience to improve further suicide prevention measures.
Consultations
Smoking in prisons. The Welsh Government is
seeking views on draft Smoke-free Premises, etc (Wales) (Amendment)
Regulations 2016 that would exempt designated prison cells in Wales
from the smoking ban for a time-limited period. The consultation
closes on 12 November 2015.
News
E-cigarettes: an emerging public health
consensus. Public Health England and other UK public health
organisations have issued a joint statement on e-cigarettes. It
sets out how the public health opportunity is in helping smokers to
quit, so while it may encourage smokers to try vaping, it certainly
encourages vapers to stop smoking tobacco completely.
Health matters: smoking and quitting in
England. Public Health England has published a new resource for
public health professionals that is designed to support
commissioning and delivering services across local areas. It
provides information on the prevalence of smoking and evidence for
what works to promote cessation at local and national level.
If you wish to discuss any queries you may have around public
health please contact Olwen
Dutton.
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Regulation
Publications/Guidance
Improving patient flow: evidence to help local
decision-makers. Guidance from Monitor to help local NHS
decision-makers evaluate options for improving patient flows
through local health and care systems.
Consultations
Our approach to regulating: Independent doctor
services. CQC is seeking views on on the regulation of
independent doctor services, such as include private GP services,
private specialists, remote consultation and provision of
treatment, travel vaccination clinics, slimming clinics, but not in
vitro fertilisation or termination of pregnancy services. It asks
whether – and how – CQC should regulate this sector and whether
these services should be rated, and also how to identify and share
notable practice. The consultation closes on 19 October 2015.
Bevan Brittan Articles
Rating the CQC - emerging themes in meeting the Duty of Candour and
Fit and Proper Person requirements . The fundamental standards
have been in place since 1 April 2015 and we are starting to
see CQC flexing its muscle.
Monitor's role in the new models of care. Monitor and the Competition and Markets Authority have jointly issued new guidance on the procedural approach to be taken at least by Foundation Trusts in relation to involvement in schemes under the Five Year Forward View for new models of care.
If you wish to discuss any queries you may have around
regulation please contact
Stuart Marchant.
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General
Publications/Guidance
Adult hearing services guidance. The National
Community Hearing Association has published a series of easy-to-use
guides to help the NHS increase access, quality and choice in adult
hearing services. They advise how to deliver the goals in the Five
Year Forward View – including putting patients first, improving
access and follow-up, delivering more care out-of-hospital and
making better use of limited resources. There are separate guides
for CCGs, providers, Healthwatch and health & wellbeing boards, as
well as checklists, price guides and an outcomes dataset.
The Assisted Dying (No.2) Bill 2015: Briefing Paper. A House of Commons Library Briefing Paper provides a background to the key cases in the area of assisted suicide and the guidance provided by the Director of Public Prosecutions, an overview of the provisions of the Assisted Dying (No.2) Bill 2015 and a summary of the progress through the House of Lords of the Assisted Dying Bill 2014.
Public hospital spending in England: evidence from
National Health Service administrative records. This paper
describes how costs vary across the lifecycle, and the
concentration of spending among people and over time. It finds that
costs per person start to increase after age 50 and escalate after
age 70. Spending is highly concentrated in a small section of the
population: with 32 per cent of all hospital spending accounted for
by 1 per cent of the general population, and 18 per cent of
spending by 1 per cent of all patients. There is persistence in
spending over time with patients with high spending more likely to
have spending in subsequent years, and those with zero expenditures
more likely to remain out of hospital.
Improving length of stay: what can hospitals
do? This report on length of stay by the Nuffield Trust is part
of a larger project undertaken by Monitor which aims to find the
best ways to improve quality of care across the health system in
light of recent pressures on urgent and emergency care. It explores
what approaches to reducing length of stay have been (and could be)
effective, providing a set of measures for improving length of stay
that are within the control of the hospital itself.
Consultations
How should we think about value in health and
care? Nesta has launched this discussion paper as part of its
wider Realising the Value programme that aims to demonstrate the
value of people and communities in their own health and care. It
asks about the elements of value in health and social care, what
people most value, and whether we have adequate ways to describe
the value that people and communities create through their
contributions to building and managing wellbeing. The ideas set out
in this paper will develop throughout the programme to underpin
future activities and outputs of the programme.
News
NHS sees 1,026 new FGM cases in three months as
recording FGM attendance becomes mandatory. The Health and
Social Care Information Centre has reported that since it began to
record female genital mutilation (FGM) data in September 2014,
there have been 4,989 cases reported nationally, and 1,026 cases
between April and June 2015 including nine girls under the age of
18. Recording FGM attendance became mandatory for acute trusts on 1
June 2015, and becomes mandatory for GP practices and mental health
trusts from 1 October 2015.
If you wish to discuss the issue of emergency care please
contact
Claire Bentley.
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