Health and Social Care Update - January 2016

Publications, legislation, cases and other developments relevant to those involved in health and social care work.

27/01/2016

Bevan Brittan provides high quality, comprehensive advice to the NHS and independent healthcare sector. This update contains brief details of recent Government publications, legislation, cases and other developments relevant to those involved in health and social care work, both in the NHS and independent sector which have been published in the last month.

If you have been forwarded this update by a colleague and would like to receive it directly, please email Claire Bentley.

Care

Information Sharing

Children

Mental Health

Clinical Risk/Health and Safety

Primary Care

Commissioning

Public Health

Employment/HR

Regulation

Finance

General

 

Care

Publications/guidance

Transforming end of life care in acute hospitals: the route to success ‘how to’ guide. This guidance builds upon the 2008 end of life care strategy for acute hospitals and includes updated practical advice and support for frontline clinicians and leaders for the work required to transform end of life care in acute hospitals.

End-of-life care and physician-assisted dying. A report from the BMA says the UK is leading the way in developing end of life care. This report outlines how the UK has led the way in the development of comprehensive and holistic care at the end of life, and we are recognised internationally for the standard and quality our healthcare system can provide. It does find that some problems persist, and there is significant scope for improvements to be made. This report sets the scene against which the qualitative research commissioned by the BMA has been conducted, outlining the context in which public, parliamentary, and professional debate has been conducted, and bringing together both peer-reviewed research and surveys of opinion.

New care models: support for the vanguards. This revised package has been updated to reflect the needs of the Urgent & Emergency Care (UEC) and Acute Care Collaboration (ACC) vanguards and includes the learning to date from the first 29 vanguards. It is the result of extensive engagement with the vanguards including site visits, workshops and discussions. Based on the feedback, the number of areas of support has been extended from eight to 10 and now includes 'new operating models' and 'governance, accountability and provider regulation'.

Pharmacy and care homes. The General Pharmaceutical Council (GPhC) has published an independent report which highlights a number of key concerns in relation to the use of medicines in care homes in Great Britain.

Transition between inpatient hospital settings and community or care home settings for adults with social care needs. Hospitals can avoid delays in discharge by making a single health or social care practitioner responsible for discharging patients, NICE says. The guidance recommends that a single health or social care practitioner should be made responsible for coordinating a person's discharge.

Better Care Fund – Policy framework. Sets out the agreed way in which the Better Care Fund will be implemented in financial year 2016 to 2017. It covers such issues as: the legal and financial basis of the fund; conditions of access to the fund; national performance metrics; and the assurance and approval process. The document needs to be read alongside the NHS Mandate.

Consultations

2016 to 2021 strategy. Consultation from CQC looking at strategy for the next 5 years.

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

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 Children

Publications/guidance

Dealing with issues relating to parental responsibility. Departmental advice about dealing with issues relating to parental responsibility. 

Commissioning guidance revised on children with complex health needs. The Department of Health has produced a revised framework designed to provide guidance to clinical commissioning groups (CCGs) when assessing the needs of children and young people whose complex needs cannot be met by universal or specialist health services. The framework is published alongside a 'decision support tool' which provides a structure to help reach decisions.

Best start in life and beyond: improving public health outcomes for children, young people and families - guidance to support the commissioning of the Healthy Child Programme 0-19: health visiting and school nursing services. This guidance is for local authorities involved with commissioning public health services for children and young people and in particular delivering the Healthy Child Programme 0-5 and 5-19. The Healthy Child Programme aims to bring together health, education and other main partners to deliver an effective programme for prevention and support. 

Consultations

Consultation on cremation following recent inquiries into infant cremations. A Ministry of Justice consultation seeks views on proposals for a number of changes to the Cremation (England and Wales) Regulations 2008, and for improving other aspects of cremation practice. It follows the Government's consideration of the recommendations of two inquiries into infant cremations. The closing date for comments is 9 March 2016. 

News

We will not stand by – failing children's services will be taken over. The Prime Minister has announced that poorly performing children’s services must improve or they will be taken over. Children’s services in local authorities, which have persistently failed in the past, will be taken over immediately. Sharper triggers will be put in place so an emergency Ofsted inspection can be ordered where there are concerns about an authority’s performance. If a local authority’s children’s services fails to improve within six months of their Ofsted inspection, a Commissioner will be put in place and high-performing local authorities, experts in child protection and charities will be brought in. 

If you wish to discuss any queries you may have around care please contact Deborah Jeremiah.

 

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Clinical Risk/Health and Safety

Bevan Brittan Training - If you are a client and 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

Preventing avoidable harm in maternity care: Department of Health capital fund 2015-16 - Information and criteria. DH guidance setting out how NHS and foundation trusts can apply for funding for equipment to prevent avoidable harm in maternity care.

Maternity services survey 2015. The findings from the CQC national survey of more than 20,000 women suggest that the majority who gave birth in February this year had a better experience overall compared to the results from previous years, across the 133 NHS trusts in England. Access to midwives, choice of where to give birth, and the quality of information are particular areas where the NHS appears to have improved. The findings highlight women’s responses to questions across themes such as access to care, personal choices, type of birth and emotional wellbeing.

Involving service users for quality improvements in maternity. This document provides case studies illustrating outcomes from trusts which took part in our Whose Shoes? maternity user experience workshops. It outlines the key learning, development and contacts for each project.

Practice guidelines for independent health complaints advocacy services. This guideline aims to provide a practical tool for local providers and commissioners to use in order to agree local service specifications, which are based on desired outcomes for the people who use the service.

NICE releases safe staffing evidence reviews. Four evidence reviews written to support work NICE carried out on staffing levels in the NHS have been released. Under the Freedom of Information (FOI) Act, the documents had been withheld to give NHS Improvement time to study them in their new remit to consider service improvement. The release of the documents follows an internal review of the FOI decision.

Hidden voices of maternity: parents with learning disabilities speak out. This research aims to capture the experience of a seldom-heard group and it offers recommendations for service improvements to support care to become more person- and family-centred. It found that support group and buddy schemes, community midwifery services and advocacy services were identified as positive aspects of service provision. However, the respondents identified staff attitudes, conflicting information and lack of support for breast feeding and when babies are taken away were the key negative experiences for parents with learning disabilities.

A framework of operating principles for managing invited reviews within healthcare. For some years, royal colleges and professional bodies involved in supporting the delivery of clinical care have offered a number of services to healthcare organisations to provide them with expert, independent, advice. These services are described as invited reviews and are offered as a way of assisting healthcare organisations across the UK to assure patient safety and improve clinical care. The purpose of the framework is to ensure that there are similar principles, standards and working practices across non-statutory external reviews of NHS clinical services carried out by colleges, professional bodies or other organisations.

News

MHRA assures UK clinical trial safety following death in France. The Medicines and Healthcare products Regulatory Agency (MHRA) has released a statement after a man, left with brain damage after an experimental drug trial in France, died. The MHRA has subsequently sought to provide assurance that no clinical trial taking place in the UK is using the same product.

University research report urges 21 NHS trusts to investigate baby death rates. In the first time that potential issues in childbirth have been highlighted at individual trust level, an inquiry led by the University of Leicester has urged 21 of the 162 NHS trusts and health boards in the UK to investigate why they have more than 10% higher stillbirth and newborn baby death rates than their peers.

Good Doctors website. The GMC has launched a new website for medical professionals and others involved in medicine to discuss and explore the real life challenges they face today. Themes covered so far include resilience, collaboration, compassion, ethics, safety, quality improvement and the doctor as a scholar.

Bevan Brittan Events
Court of Protection Update - Leeds 16 March 2016 09:30. This half day series of presentations will provide a practical update on the current mainstream issues in the Court of Protection. It will offer guidance on the sort of problems that are faced by front-line practitioners and service planners. It is aimed at all those working in organisations responsible for the care of vulnerable or incapable people both as care providers or commissioners.

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

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Commissioning

Publications/Guidance

Practice guidelines for independent health complaints advocacy services. The LGA has worked in partnership with providers and commissioners of independent health complaints advocacy services to develop practice guidance for commissioning these important local services. Collectively, providers and commissioners have a responsibility to ensure that local health complaints advocacy services are accessible, responsive, of high quality and effective in resolving complaints at the most locally appropriate level and at the earliest opportunity. This document sets out national practice guidance with which to benchmark local specifications for provision of independent health complaints advocacy services.

Putting community pharmacy at the heart of the NHS. The Government wants to better integrate community pharmacy into primary care. This letter from DH and NHS England to the Pharmaceutical Services Negotiating Committee and the pharmacy sector sets out the proposals for community pharmacy in 2016 to 2017 and beyond.

Public Contracts Regulations – New subcontracting provisions. The Public Contracts Regulations 2015 provide some additional obligations and flexibilities to enable further transparency and oversight of the working practices of the subcontracting chain, which implement the subcontracting provisions in the new Procurement Directive. There are also new obligations to meet the Government’s policy on prompt payment of invoices. This guidance explains the new rules on implementing the subcontracting provisions.

Procurement Policy Note 18/15 – New threshold levels 2016. Sets out the new threshold levels to apply for the purposes of the Public Contracts Regulations. They come into force from 1 January 2016. See also our Revised EU public procurement thresholds summary that sets out the key thresholds for public sector purchasers.

Commissioning guidance revised on children with complex health needs. The Department of Health has produced a revised framework designed to provide guidance to clinical commissioning groups (CCGs) when assessing the needs of children and young people whose complex needs cannot be met by universal or specialist health services. The framework is published alongside a 'decision support tool' which provides a structure to help reach decisions.

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

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Employment/HR

Publications and Guidance

Reform of support for healthcare students in England. This note explains the proposed changes to funding for students on NHS funded courses in England, that lead to professional registration as nurses, midwives, or other allied health professionals as announced in the Spending Review and Autumn Statement 2015. From September 2017 NHS bursaries which provide tuition fee funding, grants and living cost support, will be replaced by funding through the standard student support package of loans. The paper provides background to the proposals, data on nursing and midwifery students and gives reaction to the proposals.

The Review Body on Doctors' and Dentists' Remuneration (DDRB): written evidence from the Department of Health. The report provides information for the DDRB to consider before it makes its recommendations on changes to pay for doctors and dentists who work for the NHS.

The NHS Pay Review Body (NHSPRB) review for 2016: evidence from the Department of Health. Pay, terms and conditions for NHS staff on Agenda for Change contracts are determined by the government in the light of the recommendations from NHS Pay Review Body (NHSPRB), which takes evidence from the four UK governments, trade unions and NHS Employers before making its recommendations. This report is the Department of Health’s evidence to the NHSPRB for the 2016 to 2017 pay round.

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

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Finance

Publications and Guidance

Sustainability and financial performance of acute hospital trusts. According to this National Audit Office report, the financial performance of acute hospital trusts has significantly declined in the last year and their financial position looks set to worsen in 2015-16. It found that the deterioration in the financial position of NHS trusts and NHS foundation trusts has been severe and worse than expected, with their £843m deficit in 2014-15 representing a sharp decline from the £91m deficit reported in 2013-14. Overall, the financial position of NHS bodies worsened in 2014-15, as NHS commissioners, NHS trusts and NHS foundation trusts together moved from a surplus of £722m in 2013-14, to a deficit of £471m.

Hospitals get £1.8 billion for sustainability and transformation. The DH has announced a Sustainability and Transformation Fund to help challenged hospitals to achieve financial balance while focusing on changing the way they provide high quality care for patients. The fund, which will be allocated dependent on hospitals meeting a series of strict conditions, will give the NHS the time and space it needs to put transformation plans in place. This will make 7 day services a reality for patients and will meet the ambitions of the NHS Five Year Forward View. The funding will be broken down into two parts: a proportion of funding will be distributed to all providers of emergency care, linked to demonstrating initial progress against the conditions outlined above and the setting of agreed control totals with NHS Improvement. A second element will be used to target providers which can deliver additional efficiencies and improvements. The initiative will be led by NHS Improvement, NHS England and the DH, who will shortly write to trusts with details of how funding will be distributed.

NHS clampdown on staffing agencies saves millions of pounds. Figures released by the health regulator, NHS Improvement, show that the amount hospitals spend on management consultants has fallen sharply over the last few months by £42m - from £145m in July-September 2014 to £103m in the same period in 2015. The clampdown, part of a wider package of spending controls announced in June aimed at supporting hospitals to improve hospital finances, also targeted 'rip off' staffing agencies including limiting the amount hospitals could pay for agency staff.

Delivering the Forward View: NHS Shared Planning Guidance 2016/17 – 2020/21. Sets out the steps to help local organisations deliver a sustainable, transformed health service and improve the quality of care, wellbeing and NHS finances. The planning guidance is backed up by £560bn NHS funding, including a new Sustainability and Transformation Fund which will support financial balance, the delivery of the Five Year Forward View, and enable new investment in key priorities. As part of the planning process, all NHS organisations are asked to produce two separate but interconnected plans:    A local health and care system Sustainability and Transformation Plan, which will cover the period October 2016 to March 2021; and    A plan by organisation for 2016/17. This will need to reflect the emerging Sustainability and Transformation Plan.

A zero cost way to reduce missed hospital appointments. This randomised controlled trial tested the effectiveness of the reminder message sent to outpatients. Results showed if the message included the specific cost to the NHS of not attending then the patient was more likely to attend or rearrange their appointment – rather than miss it.

The Government's mandate to NHS England for 2016-17. The DH has published the Mandate that helps set direction for the NHS and helps ensure the NHS is accountable to Parliament and the public. The mandate must be published each year, to ensure that NHS England’s objectives remain up to date. This mandate was produced following public consultation. It reaffirms the Government’s commitment to an NHS that remains available to all, based on clinical need and not ability to pay, and that is able to meet patients’ needs and expectations now and in the future. The accompanying Financial Directions set out certain additional and expenditure controls to which NHS England must adhere. These stem from budgetary controls that HM Treasury applies to the DH. 

Royal College of Midwives report: spending on agency midwives in England. This report is a result of freedom of information (FOI) requests that the RCM sent to 136 NHS trusts in England last year about spending on agency nurses. The FOI had a response rate of over 95 per cent with 130 trusts responding and it found that over 73 per cent of trusts in London with maternity services rely on agency midwives to staff their services. As a result, the spend on agency midwives has increased from £10,159,099 in 2012 to £17,849,767 in 2014 - representing an increase of almost 76 per cent.

News

Financial performance and quality must work together. The CQC’s Chief Inspector of Hospitals, Professor Sir Mike Richards, and the Chief Executive of NHS Improvement, Jim Mackey have written to all 255 NHS hospital trusts in England to ask that financial performance and quality must work together, and be considered as combined and equal priorities. It recognises the role that CQC and NHS Improvement have in enabling trusts to deliver the right finance / quality balance. Some hospital trusts make millions a year from car parks. The BBC reports that an investigation has shown hospitals were making increasing amounts of money from staff, patients and visitors who used their car parks. It also found hospitals were giving millions of pounds to private firms to run their car parks for them, with some receiving money from parking fines. Others are tied into private finance initiative contracts, where all the money charged from car parks goes to companies under the terms of the scheme. Seven NHS trusts earned more than £3m in 2014-15 from charges, another eight made more than £2m a year and a further 33 earned more than £1m a year.

Prime Minister pledges a revolution in mental health treatment. The Prime Minister has announced almost £1bn of investment to enhance mental health services across the country. The funding includes: £290m of new investment over the next 5 years to provide mental healthcare for new mothers; £247m to invest in liaison mental health services in emergency departments; over £400m to enable 24/7 treatment in communities as a safe and effective alternative to hospital; and extended services to help teenagers with eating disorders.

If you wish to discuss any issues raised in this section please contact Claire Bentley.

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Information Sharing

Publications/Guidance

How to disclose information safely – Removing personal data from information requests and datasets. Guidance for organisations disclosing information which has been derived from personal data and requires further processing to ensure that individuals cannot be identified from that information. It explains some of the most common types of inappropriate disclosures that the ICO has seen in recent years. It also includes other types that data controllers and public authorities should be aware of.

News

Government to get access to NHS sick note records. From February 2016 the Department for Work and Pensions is to be given access to NHS records to identify which GP practices hand out the most sick notes. The Government hopes that the data, which will show how many computer-generated fit notes are issued, how many patients are recorded as unfit or maybe fit for work, and the length of the fit note, will provide a "better understanding of why people take sickness leave in different parts of the country". ICO criticises "disappointing attitude" of dementia charity. The ICO has found serious failings in the way volunteers at a national dementia support charity handled sensitive personal data. It has ordered The Alzheimer’s Society to take action after discovering that volunteers were using personal email addresses to receive and share information about people who use the charity, storing unencrypted data on their home computers and failing to keep paper records locked away. ICO fines HIV patient support service for data breach. The ICO has fined the Bloomsbury Patient Network after it inadvertently revealed the identities of HIV patients through an email error. The network, which offers support to patients, sent out a newsletter via email using a list of email addresses in the ‘to’ field rather than the ‘bcc’ field to 200 patients. On receiving the email the recipients on the list could see all the individual email addresses. Many of them contained people’s names, which resulted in 56 patients’ full or partial names being revealed.

If you wish to discuss any of the items raised in the above section please contact Jane Bennett.

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Mental Health

Bevan Brittan Training - If you are a client and 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

Dementia in the family: the impact on carers. This report highlights the the realities of daily life for carers who are looking after their loved ones and reveal how dementia changes family relationships, leaving people feeling socially isolated, and affects both the health and finances of family carers. The findings underline the importance of research to provide new treatments capable of reducing care needs for people with the condition.

Mazars – independent review – Southern Health NHS Foundation Trust. NHS England has published an independent report into the deaths of people with a learning disability or mental health problem at Southern Health NHS Foundation Trust, and highlighted a system-wide response.

Department of Health Guidance: Response to the Supreme Court judgment / Deprivation of Liberty Safeguards. Updated guidance as a result of the Supreme Court judgment of 19 March 2014 in P v Cheshire West and Chester Council that clarified an "acid test" for what constitutes a "deprivation of liberty", and subsequent judgments which have significant implications for the use of Deprivation of Liberty Safeguards (DoLS). It includes examples of actions taken by local partners in responding to increased numbers of DoLS applications.

Dementia: post-diagnostic care and support. Sets out a joint declaration across government, health, social care and the third sector to deliver better quality services to people with dementia, their families and carers following a diagnosis.

Progress report on Think Autism: The updated strategy for adults with autism in England. This report shows what has been achieved since the publication of 'Think Autism', which updated the cross-government autism strategy in April 2014. It also sets 31 new actions to continue to help local areas implement the autism strategy. The report also outlines work to help people with autism live as full and independent lives as possible.

Fix dementia care: hospitals. This investigation into the quality and variation in hospital care for people with dementia has found that too many people with dementia are falling while in hospital, being discharged at night or being marooned in hospital despite their medical treatment having finished. The report launches a campaign to introduce annual statements of dementia care from each hospital, including feedback from patients with dementia, helping to raise standards of care across the country. It also calls for regulators such as Monitor and Care Quality Commission to include standards of dementia care in their assessments.

Consultations

Department of Health response to the Law Commission's consultation on mental capacity and deprivation of liberty. Sets out the Government's response to the Law Commission’s consultation on how the law should regulate deprivations of liberty (DoLS) for people who lack capacity to consent to their care and treatment arrangements. The consultation proposes that DoLS should be replaced by a new system called ‘protective care’; it also proposes that there should be a new code of practice. The Law Commission will publish its final recommendations by the end of 2016.

Legislation

Mental Health Act: exercise of approval instructions 2015. Department of Health revised instructions lay out the function of approving registered medical practitioners and of approving individuals to act as approved clinicians under the Mental Health Act 1983.

News

Prime Minister pledges a revolution in mental health treatment. The Prime Minister has announced almost £1bn of investment to enhance mental health services across the country. The funding includes: £290m of new investment over the next 5 years to provide mental healthcare for new mothers; £247m to invest in liaison mental health services in emergency departments; over £400m to enable 24/7 treatment in communities as a safe and effective alternative to hospital; and extended services to help teenagers with eating disorders.

Bevan Brittan Events
Court of Protection Update - Leeds 16 March 2016 09:30. This half day series of presentations will provide a practical update on the current mainstream issues in the Court of Protection. It will offer guidance on the sort of problems that are faced by front-line practitioners and service planners. It is aimed at all those working in organisations responsible for the care of vulnerable or incapable people both as care providers or commissioners.

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

News

Manchester GPs launch a new 7 day service. Speech by Alistair Burt MP on the Manchester Primary Care Partnership scheme making thousands of extra GP appointments available at evenings and weekends.

Specialist eye care services to be provided closer to people’s homes. The Welsh Government has announced that £400,000 funding to set up four pilot projects in Gwent, Cwm Taf, West Wales and Powys. Assessment and treatment services for people with wet-AMD, which can cause swift sight loss, will be moved out of hospitals and into local communities, where they will be delivered by optometrists and nurses, overseen by an ophthalmologist.

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

NHS public health functions agreement 2016-17. This agreement sets out the arrangements under which the Secretary of State delegates responsibility to NHS England for certain public health services (known as Section 7A services). It aims to improve public health outcomes and reduce health inequalities and contribute to a more sustainable public health, health and care system.

Weight management services: national mapping. PHE has published a report on the provision of tier 2 and tier 3 weight management services for children, young people and adults that are locally commissioned through local authorities and clinical commissioning groups. It provides insights into how these services are delivered across England including: referral routes and entry criteria; service details; costs; exit routes; and barriers to commissioning services.

Working together to reduce harm – Delivery plan 2016 – 2018. The Welsh Government is seeking views on a draft Delivery Plan that explains what it will do over the next three years to improve the outcomes of those affected by substance misuse. The consultation closes on 30 March 2016.

Impact of insecure accommodation and the living environment on gypsies’ and travellers’ health. This report by the Traveller Movement looks at how the living conditions of gypsies and travellers lead to poor health. It finds that two-thirds of gypsies and travellers reported poor, bad, very bad or health , with their living conditions significantly contributing to their physical and mental health, and the poor health of gypsies and travellers is made worse by their living environment, accommodation insecurity and community discrimination. It concludes that there needs to be closer partnership working across health and other interests to address these issues.

NHS England annual accountability statement for NHS public health. The NHS Public Health Functions Agreement requires NHS England to produce an annual report on its achievement against the outcomes set out in the agreement. This accountability statement assesses NHS England’s performance against the agreement for 2014 to 2015.

Health promotion for sexual and reproductive health and HIV: strategic action plan, 2016 to 2019. This strategic action plan sets out PHE’s approach to improving the public’s sexual and reproductive health and reversing the HIV epidemic. It identifies the key areas for PHE action, and describes how PHE can work with partners at a national and regional level to improve health and reduce inequalities.

Consultations

Consultation on the Draft Public Health Outcomes Framework for Wales. The Welsh Government is seeking views on a draft Public Health Outcomes Framework for Wales that has been developed in the context of other strategies and frameworks that also seek to improve the health of the people of Wales. In particular, it links to the national indicators for the Wellbeing of Future Generations (Wales) Act 2015, which are also currently undergoing consultation and development. The consultation closes on 28 January 2016.

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

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Regulation

Publications/Guidance

Proposals for changing the system of midwifery supervision in the UK. In preparation for changes to the statutory supervision of midwives, to be introduced in 2017, a proposed new system will separate midwifery supervision and regulation. The proposals have been developed by the UK Chief Nursing Officers, their midwifery advisors, the Nursing and Midwifery Council (NMC), the Royal College of Midwives and a representative of the Local Supervising Authority Midwifery Officers. Guidance from the Department of Health (DH) outlines the next steps in the legislative process and makes proposals for the redesign of a future system of supervision for midwives.

Consultations

2016 to 2021 strategy. Consultation from CQC looking at strategy for the next 5 years.

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

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General

Publications/Guidance

Alcohol-specific activity in hospitals in England. This report investigates the growing burden of alcohol-related activity on hospitals in England and concludes that the NHS faces a ‘stark challenge’ in trying to deal with the consequences of harmful drinking. It finds that emergency admissions to hospital specific to alcohol have increased by over 50% in nine years and now top a quarter of a million a year, while the rate of people attending A&E with probable alcohol poisoning has doubled in six years. The authors of the report set out to assess the extent of alcohol-specific activity in hospitals in England, whether it had increased over time, and whether these trends were different across demographic, socio-economic and regional patterns.

Transgender equality. This report finds that, despite welcome progress, there is still a long way to go to ensure equality for transgender people. It finds that trans people have significant problems in using general NHS services – often because of lack of knowledge and understanding by staff. The report recommends that a root and branch review of these issues should be completed within the next six months. 

Annual report of the Chief Medical Officer, 2014: The health of the 51%: Women. This report examines women’s health in England and makes a range of recommendations to improve it. It identifies several missed opportunities for intervention in women’s health, and brings attention to ‘embarrassment’ as a needless barrier to health. It makes recommendations on a wide range of health issues, most notably obesity, ovarian cancer and ‘taboo problems’ such as incontinence and the menopause.

The A&E winter crisis: lessons from last year. New analysis by the Nuffield Trust of pressures on the NHS last winter has found that just 3.6 per cent of patients took up over a third of all bed capacity in acute hospitals in England last year. The authors say that this new figure for bed occupancy helps to explain why the Health Service still suffered a winter ‘crisis’ last year, despite receiving record extra funding from NHS England of almost £700m specifically to deal with pressures caused by winter. They argue that the position will be even worse in the coming months as no extra funding for winter is being allocated this year. The research shows the breadth of measures adopted by Trusts last winter to try to deal with additional demand, and the amount spent on each from the £652 million 'pot'.

The digital revolution: eight technologies that will change health and care. The past decade has seen rapid development and adoption of technologies that change the way we live. But which technologies will have a similarly transformative impact on health and care? We have already looked at some examples of innovative technology-enabled care that are already being deployed in the NHS and internationally to transform care. Now, we examine the technologies most likely to change health and care over the next few years which could represent an opportunity to achieve better outcomes or more efficient care.

Efficiency, equity and equality in health and health care. Three common “Es” have high ethical and political content for health policy: efficiency, equity and equality. This paper examines the links between the three, with especial attention given to (a) the claimed conflict between efficiency and equity, (b) the equity of inequalities and (c) the conflict between six equity principles: equal health, equal health gain, equal value of additional health, maintaining existing distributions, allocation according to need and equal per capita resources.

The Government's mandate to NHS England for 2016-17. The DH has published the Mandate that helps set direction for the NHS and helps ensure the NHS is accountable to Parliament and the public. The mandate must be published each year, to ensure that NHS England’s objectives remain up to date. This mandate was produced following public consultation. It reaffirms the Government’s commitment to an NHS that remains available to all, based on clinical need and not ability to pay, and that is able to meet patients’ needs and expectations now and in the future. The accompanying Financial Directions set out certain additional and expenditure controls to which NHS England must adhere. These stem from budgetary controls that HM Treasury applies to the DH. 

Health inequality and the A&E crisis. This research briefing finds that the richest fifth of people in England can expect to live at least 12 more years of life in full health than the poorest fifth. Despite their shorter lives, poorer people make more use of NHS services – especially emergency services. It concludes that many emergency admissions to hospital are preventable by more effective primary care, community care and hospital outpatient care for long-term conditions.

Health equity indicators for the English NHS. This research highlights the breadth of health inequalities between the richest and poorest in England. It finds that the richest fifth of people in England can expect to live at least 12 more years of life in full health than the poorest fifth. Despite their shorter lives, poorer people make more use of NHS services - especially emergency services. It identifies reducing inequality in health care outcomes rather than access to care as a priority for the NHS.

News

Early access to melanoma treatment for UK patients More than 500 patients in the UK with advanced melanoma will be among the first in the world to access new skin cancer treatments through the early access to medicines scheme (EAMS). The move means the patients will benefit from the treatment before being licensed.

NHS hospitals to introduce sugar tax. The NHS has unveiled plans to implement its own sugar tax in hospitals to help tackle concerns over sugar induced obesity. NHS chief executive Simon Stevens has urged government ministers to take action, including obligating food firms to cut down on the amount of sugar in their products.

If you wish to discuss any issues raised in this section please contact Claire Bentley.

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