Health and Social Care Update - April 2016

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

29/04/2016

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

Foundation Trusts 

 

 

Care

Publications/guidance

Administration of medicines in care homes (with nursing) for older people by care assistants. This guidance sets out good practice measures for the safe management and handling of medicines in care homes (with nursing) for older people by care assistants. The guidance includes: the legal framework for the administration of prescribed medicines for a named individual by care assistants; and safety and quality assurance requirements.

A practical guide to healthy caring. The Care Act 2014 introduced new duties on local authorities and health bodies to provide information and support to carers. This guide provides information and advice to carers about staying healthy whilst caring and identifies the support available to help carers maintain their health and wellbeing. While it is aimed at carers of any age, it is particularly relevant for carers aged around 65 years and those new to caring.

Care after cure: Creating a fast track pathway from hospitals to homes. This report from ResPublica argues that delayed transfers of care, and the high costs that go with caring for patients who no longer need specialist acute care, must be resolved to free up much needed hospital capacity. It examines how to reduce pressures on the NHS by making better use of existing residential care facilities, and asks what is needed to allow residential care to step up and take on a more substantial role in the health and social care ecosystem through working more closely with providers of healthcare. The report proposes a 'Fast Track Discharge Fund', worth more than £3bn over the next five years and funded out of existing NHS budgets, to both pay for residential care beds to accommodate patients with no medical need to be in hospital, and invest in skills, training and facilities within the residential care sector.

End of Life Care Audit. The results of the new end of life care audit run by the Royal College of Physicians show that there has been steady progress in the care of dying people since the previous audit carried out in 2013 and published in 2014. The audit, funded by NHS England and Marie Curie, and commissioned by the Healthcare Quality Improvement Partnership (HQIP), is the first to be carried out following the official withdrawal of the Liverpool Care Pathway (LCP) in 2014, although some hospitals had already started to replace the LCP with local policies before the previous audit. The new audit is a much more detailed investigation of the care of dying people against the five priorities of care established in ‘One Chance to Get it Right’, but includes some similar questions to the 2013 audit, to allow direct comparisons. 

Commissioning person centred end of life care – a toolkit for health and social care. This updated guide identifies the main elements involved in commissioning end of life care services, explains the commissioning cycle in practical terms and offers a staged approach. It also provides a wide range of links to tools and sources of support for both commissioners and providers of services. It showcases good practice and seeks to indicate what a well-commissioned end of life care service looks like.

A practical guide to healthy caring. The Care Act 2014 introduced new duties on local authorities to provide information and support to carers. This guide provides information and advice to carers about staying healthy whilst caring and identifies the support available to help carers maintain their health and wellbeing. While it is aimed at carers of any age, it is particularly relevant for carers aged around 65 years and those new to caring.

Legislation

Care Act 2014 (Commencement No. 5) Order 2016 (SI 2016/464 (C.25)). This Commencement Order brings certain provisions in the 2014 Act relating to Wales into force on 6 April 2016.

Social Services and Well-being (Wales) Act 2014 (Commencement No. 3, Savings and Transitional Provisions) Order 2016 (SI 2016/412 (W.130) (C.21)). The 2014 Act imposes duties on local authorities, health boards and Welsh Ministers that require them to work to promote the wellbeing of those who need care and support, or carers who need support. This Order brings the remaining provisions of the 2014 Act into force in Wales on 6 April 2016.
Welsh local authorities, when exercising their social services functions, must act in accordance with the requirements contained in the Codes of Practice. Local authorities and Local Health Boards must have regard to the statutory guidance in relation to partnership arrangements which are required under s.166 of the Act. 

News

£60m to join up health and social care services. Announces funding from the Welsh Government’s intermediate care fund in 2016-17 to improve care coordination between social services, health, housing, education and the third and independent sector through innovating and enhancing schemes which: support frail and older people; develop integrated services for people with learning disabilities and children with complex needs; and develop an integrated autism service, focusing on a multidisciplinary team to support autism in adults and enhancing existing children’s neuro-developmental services.

Nearly two million patients to receive person-centred support to manage their own care. Announces that NHS England has agreed a deal which will grant nearly 2m people access to more person-centred care as part of its developing Self Care programme. Local NHS organisations and their partners are being invited to apply for free access to patient activation licences, which will help them assess and build their patients’ knowledge, skills and confidence, empowering people to make decisions about their own health and care.   

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

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Children

Publications/guidance

CentreForum Commission on Children and Young People's Mental Health: State of the nation. This first report from the Commission reveals the problems that young people face when trying to access mental health care. Services turn away, on average, nearly a quarter (23 per cent) of children and teenagers referred to them by their GPs, teachers or others. The analysis of services’ eligibility criteria shows that this is often because there are high thresholds for access to their services, preventing often the most effective treatment of mental health conditions - early intervention.

Tackling poor oral health in children: local government's public health role. Commissioning responsibilities of the Healthy Child Programme for 0-5 year olds were transferred to local government in October 2015. This included the commissioning of Health Visitors who lead and support delivery of preventive programmes for infants and children including providing advice on oral health and on breastfeeding and reducing the risk of tooth decay. This updated LGA publication looks at local authorities' role and includes a number of case studies.

Helping healthcare staff spot the signs of child sexual exploitation. A new video aimed at helping health and social care professionals to spot possible signs of child sexual exploitation

Multi-agency statutory guidance on female genital mutilation (FGM). These multi-agency guidelines on FGM are aimed at those with statutory duties to safeguard children and vulnerable adults. It supersedes the previous guidance issued in 2014, 'Female genital mutilation: guidelines to protect women and children'.   

If you wish to discuss any queries you may have around children 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

Guidance for doctors who offer cosmetic interventions. Doctors who carry out cosmetic procedures must advertise and market their services responsibly, give patients time to change their mind and prioritise patient safety, as set out in new guidance from the General Medical Council (GMC). The guidance has been produced following a review of the cosmetic industry in England. It comes into force from June 2016, and covers both surgical (eg breast augmentation) and non-surgical (eg Botox) procedures.

Professional standards for cosmetic surgery This guidance has been updated with the aim of improving patient safety and standards within the cosmetic surgery industry. It stipulates that only surgeons with the appropriate training and experience should undertake cosmetic surgery and outlines the ethics and behaviour expected of cosmetic surgeons. It supplements new guidance produced by the General Medical Council today for all doctors who carry out cosmetic intervention and is intended to be read alongside this guidance.

Patterns of maternity care in English NHS hospitals 2013-14. This report from the Clinical Indicators Project presents 18 indicators that can be used to compare the performance of English NHS trusts in maternity care. It shows substantial variation in practice between NHS trusts in England and it makes a number of key recommendations to NHS trusts, commissioners and researchers.

CQC review of how NHS trusts investigate and learn from deaths. Following the Government's response to a report into deaths of persons with mental health problems in contact with Southern Health Foundations NHS foundation trust, the Care Quality Commission (CQC) is to carry out a review of the quality of practice by NHS trusts when investigating such deaths. The review will also focus on how trusts can learn from the deaths of those with learning disabilities and mental health issues.

Medicines – Packaging, labelling and patient information leaflets. Medicine guidance regarding packaging, labelling and patient information leaflets (PILs) has been updated by the Medicines and Healthcare products Regulatory Agency (MHRA). A new section on safety feature legislation, especially on the unique identifier and tamper feature, has been added.

Transfers of premature and sick babies. This report highlights the challenges faced by neonatal transport services in the UK. Findings reveal that these essential services are often under-staffed, under-resourced and part-time. It shows that in a one week snapshot, half of the neonatal transport services across the UK reported gaps in their rota.  

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

Sustainability and Transformation Plans - A major new development in commissioning health and care. Sustainability and Transformation Plans (STPs) are joint plans produced by NHS providers, CCGs, local authorities and other health and care services (including VCSE partners) for 44 'footprint' geographical areas across England. These will form the basis for long term, place based planning and commissioning of services. This briefing from Regional Voices provides more details. It highlights how the six principles to support delivery of the NHS Five Year Forward View can help the voluntary and community sector get involved in developing the plans.

Commissioning rehabilitation services. Guidance for CCGs to support them in commissioning rehabilitation services for their local population. It contains evidence and examples of good practice, along with practical advice to commission good quality rehabilitation including ten top-tips. 

Guidance for commissioners of psychiatric intensive care units (PICU). This guidance was produced in partnership with the National Association of Psychiatric Intensive Care and Low Secure Units (NAPICU) to support the commissioning of high-quality PICUs and improve patient experience. It seeks to empower and enable commissioners, managers and clinicians to jointly develop high quality PICUs. It provides summary guidance which will assist commissioners to meet the needs of their local population, and achieve the ambitions of the Five Year Forward View focusing on patient safety, clinical effectiveness and patient experience.

Framework for patient and public participation in primary care commissioning. Guide for primary care commissioners in NHS England and CCGs on how to involve patients and the public in the commissioning of primary care services. 'Patients and the public' includes service users and carers, and participation in primary care commissioning refers to how people are involved in planning (including policy making and relevant programmes), buying and monitoring primary care services. 'Primary care' includes general practice, community pharmacy, dental, and optometry (eye health) services.
There is also information for patients and the public on How to get involved in primary care commissioning.

Smokers and overweight patients: soft targets for NHS savings? This report explores how widespread the practice of restricting surgery on the basis of weight or smoking status has become by examining the commissioning policies of CCGs in England. The report compares these against guidance produced by NICE, RCS and surgical specialty associations. It found that over one in three CCGs in England are denying or delaying routine surgery to patients - such as hip and knee replacements - until they stop smoking or lose weight, in contravention of national clinical guidance. 

Implementing the Cancer Taskforce Recommendations: Commissioning person centred care for people affected by cancer. This guidance is intended to support commissioners and strategic clinical networks to take the actions necessary to drive improved outcomes for person centred care through cancer commissioning. It describes the actions that need to be taken to ensure that every person affected by cancer will have access to the Recovery Package and stratified follow up pathways by 2020, including checklists for developing service specifications, practical examples and templates to use and adapt locally.

Commissioning person centred end of life care – a toolkit for health and social care. This updated guide identifies the main elements involved in commissioning end of life care services, explains the commissioning cycle in practical terms and offers a staged approach. It also provides a wide range of links to tools and sources of support for both commissioners and providers of services. It showcases good practice and seeks to indicate what a well-commissioned end of life care service looks like.

Consultations

Developing a method to assist investment decisions in specialised commissioning. Seeks views on on a method to be used by NHS England's Clinical Priorities Advisory Group when comparing competing priorities when it meets to agree recommendations on the relative prioritisation of new investments in specialised services. The consultation closes on 11 May 2016.

News

NHS England takes robust action on conflicts of interest. Announces plans for a comprehensive package of measures aimed at clamping down on conflicts of interest and ensuring the NHS is one of the leading healthcare organisations in the world in tackling such issues. The plans include revised guidance for CCGs on managing conflicts of interest, that will contain a number of strengthened measures, e.g. publicly available registers of gifts and hospitality and increasing the number of lay members on CCG governing bodies to support conflict of interest management and provide extra scrutiny. The draft revised guidance will be issued for consultation in April 2016, with the final version scheduled for June 2016. There will also be a new requirement on providers in the 2016/17 NHS Standard Contract to maintain and publish a register of gifts, hospitality and conflicts of interest, to ensure that there is greater transparency in place.

Monitor is now part of NHS Improvement. Announces that from 1 April 2016, Monitor is part of NHS Improvement which brings together Monitor, NHS Trust Development Authority, Patient Safety, the National Reporting and Learning System, the Advancing Change Team and the Intensive Support Teams. 

Bevan Brittan Events

Taking stock of NHS governance after the 2013 reforms: Public procurement, competition and conflicts of interest in NHS commissioning. 23 June 2016 09:00. University of Bristol Law School, with the generous sponsorship of PolicyBristol and Bevan Brittan, and supported by the Elizabeth Blackwell Institute for Health Research. This event has two main objectives. First, it intends to bring together CCGs, NHS Trusts, legal practitioners and academics, so that we can collectively take stock of this aspect of the new NHS governance framework almost 3 years after its adoption. 

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

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Employment/HR

Guidance and Publications

Shaping the future of medical revalidation: interim report. This report from the GMC presents emerging findings from a study into the regulatory impacts of revalidation. It finds that the majority of GMC licensed doctors are engaged in an annual appraisal process but scepticism was expressed about whether revalidation has led to improved patient safety. The majority of responsible officers surveyed felt that the numbers of concerns about doctors had not increased since the introduction of revalidation. The report also highlights the lack of awareness on the part of patients and the public on revalidation and the purposes of the process.

Supporting NHS staff who are volunteers. This guidance for NHS employers looks at the business case and benefits of volunteering. It outlines the impact it has on an employee’s terms and conditions and gives examples from Northumbria Healthcare NHS Foundation Trust and Cambridge University Hospitals NHS Foundation Trust who have both supported their staff to take part in volunteering activities.

Terms and conditions of service for NHS doctors and dentists in training 2016. This contract outlines the new terms and conditions of the junior doctors' contract which will be introduced in August 2016. The accompanying and supporting documentation includes FAQs and details on the new Guardian for Safer Working role.

Junior doctors' contract: equality analysis and family test. Equality analysis and family test for the new contract for doctors and dentists in training in the NHS.

Transfers of premature and sick babies. This report highlights the challenges faced by neonatal transport services in the UK. Findings reveal that these essential services are often under-staffed, under-resourced and part-time. It shows that in a one week snapshot, half of the neonatal transport services across the UK reported gaps in their rota.

Shaping the future of medical revalidation – interim report. This GMC report presents emerging findings from the UMbRELLA (UK Medical Revalidation Evaluation Collaboration) study into the regulatory impacts of revalidation. it finds that four out of 10 doctors are changing their practice as a result of their last appraisal. A majority of responding Responsible Officers (62.7%) felt that the number of concerns being raised about doctors had not increased since the introduction of revalidation.

Consultations

Reforming healthcare education funding: creating a sustainable future workforce . The DH is seeking views on proposals that, from 1 August 2017, all new nursing, midwifery and allied health professional students on pre-registration undergraduate and post-graduate courses will receive their tuition funding and financial support through the standard student support system, rather than NHS bursaries and tuition funded by Health Education England. An open consultation on the proposals seeks views on how these reforms can be implemented. The consultation closes on 30 June 2016.

The Nursing and Midwifery Council - amendments to modernise midwifery regulation and improve the effectiveness and efficiency of fitness to practise processes. Seeks views on a draft Amendment Order making changes to the Nursing and Midwifery Order 2001 that will: remove statutory midwifery supervision provisions, which will result in a clear separation of the roles and purpose of the supervision and regulation of midwives; remove the statutory Midwifery Committee from the NMC’s governance structures; and make improvements to the NMC’s fitness to practise processes to enable further improvements and deal with cases in a more appropriate manner. The consultation closes on 17 June 2016.

Consultation on standards for pharmacy professionals. The General Pharmaceutical Council is seeking views on core standards that every pharmacist, pharmacy technician, pharmacy student and trainee will be expected to meet. The nine core standards describe the attitudes and behaviours that contribute most to safe and effective care. The closing date for responses is 27 June 2016.

News

Healthcare professionals have no duty of care regarding patients' families, High Court rules. The High Court has dismissed a compensation claim against the NHS from a man who is suffering from incurable brain disease from which his younger sibling died, and with which a cousin was also diagnosed. The claimant argued that his condition was genetic and should therefore have been diagnosed earlier and treated. The Court ruled that a doctor's duty of care to their patients did not extend to patients' wider families.

Damages claim rejected for psychiatrist’s work-related heart attack. The Court of Appeal has dismissed an appeal from a psychiatrist who suffered a stress-related heart attack at work. The High Court had rejected her claim for damages from an NHS Trust due to being overworked. The Court of Appeal upheld the High Court ruling on the grounds that, even though the Trust had failed to carry out a relevant risk assessment, it would have made no difference to the claimant’s levels of stress.

Bevan Brittan Articles

Bad news for malingerers. Malingerers beware: the EAT has made it easier for you to be dismissed. Sarah Maddock reports.

Employment news round-up - April 2016. Julian Hoskins provides this month's round-up of key employment law developments.

Whistleblowing takes centre stage. Victoria McMeel and Jodie Sinclair look at where we are on new standards recently introduced and the latest case law on what a 'public' interest disclosure means.

Bevan Brittan Events

Junior doctors' banding claims - Hear from industry experts. Although there is a lot of uncertainty about the introduction of the new junior doctors' contract in 2016, NHS Trusts are continuing to face an increasing number of banding appeals and claims arising from non-compliant rotas. The BMA is supporting more and more claims and many Trusts are defending proceedings issued in the Employment Tribunal or the civil courts.
Birmingham - 4 May 09.30
Bristol - 12 May 09.30  

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

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Finance

Publications and Guidance

NHS National Tariff Payment System 2016/17. This year’s national tariff comes into effect from 1 April 2016. It aims to give providers of NHS services the space to restore financial balance and support providers and commissioners to make ambitious longer term plans for their local health economies.
Monitor and NHS England have also published a number of supporting documents to be read alongside the 2016/17 national tariff. 

Smokers and overweight patients: soft targets for NHS savings? This report explores how widespread the practice of restricting surgery on the basis of weight or smoking status has become by examining the commissioning policies of CCGs in England. The report compares these against guidance produced by NICE, RCS and surgical specialty associations. It found that over one in three CCGs in England are denying or delaying routine surgery to patients - such as hip and knee replacements - until they stop smoking or lose weight, in contravention of national clinical guidance. 

News

Tens of millions to be reinvested in patient care thanks to NHS devices deal. NHS England and NHS Business Services Authority have agreed a single national approach for purchasing and supplying expensive medical devices such as implantable cardioverter defibrillators. The new system for hospital trusts to order devices for specialist services will be operated by NHS Supply Chain. All Trusts currently purchasing these high-cost devices will be contacted by NHS England and NHS Supply Chain in a phased approach from April 2016. NHS Supply Chain will provide a full programme of support to each Trust to ensure a smooth migration over to the new arrangements before the end of 2016. This press release gives more details and lists the devices covered by the agreement.

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

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Foundation Trusts

Publications/Guidance 

NHS foundation trust quality reports: 2015/16 requirements. Guidance from Monitor on the details of contents and assurance requirements for NHS foundation trusts preparing their 2015/16 quality reports.

If you wish to discuss any issues raised in this section please contact Vincent Buscemi.

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Information Sharing

Publications/Guidance

A paperless NHS: electronic health records. This briefing from the House of Commons Library outlines the current use of electronic health records in the NHS in England in relation to the pledge that the NHS will be paper-free by 2020. 

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

Mental health and criminal justice: views from consultations across England & Wales. With extremely high rates of mental ill-health among the prison population, this report draws on experiences from across England and Wales to determine the way forward for improvement. It finds that few of the prisons represented at the events were able to offer psychological therapies, and that primary mental health care remains the weakest element of mental health support in prisons.

Mental health services: preparations for improving access. Progress is being made by the Department of Health (DH) and NHS England in improving access to mental health services, the National Audit Office (NAO) has found, but significant risks to implementing the access and waiting times programme remain. The NAO's report finds the strongest areas are the clear objectives and strong leadership, with a governance framework being developed. The greatest challenges for the future are collecting data to show whether the standards are being met, building the mental health workforce and reinforcing incentives for providers. The NAO report is the first in a planned programme of work on mental health.

Integrated care to address the physical health needs of people with severe mental illness: a rapid review. People with mental health conditions have a lower life expectancy and poorer physical health outcomes than the general population. Evidence suggests that this discrepancy is driven by a combination of clinical risk factors, socioeconomic factors and health system factors. The objective of this research was to explore current service provision and map the recent evidence on models of integrated care addressing the physical health needs of people with severe mental illness primarily within the mental health service setting.

Office of the Public Guardian: Written question - 34212. Mental health In response to a written question asking if the Secretary of State for Justice will hold a public consultation on the level of fees charged by the Office of the Public Guardian (OPG), the Ministry of Justice states that work to review the OPG's fee structure is ongoing. It adds that, depending on the outcome of that work, a consultation will be published in due course if required.

CQC review of how NHS trusts investigate and learn from deaths. Following the Government's response to a report into deaths of persons with mental health problems in contact with Southern Health Foundations NHS foundation trust, the Care Quality Commission (CQC) is to carry out a review of the quality of practice by NHS trusts when investigating such deaths. The review will also focus on how trusts can learn from the deaths of those with learning disabilities and mental health issues.

CentreForum Commission on Children and Young People's Mental Health: State of the nation. This first report from the Commission reveals the problems that young people face when trying to access mental health care. Services turn away, on average, nearly a quarter (23 per cent) of children and teenagers referred to them by their GPs, teachers or others. The analysis of services’ eligibility criteria shows that this is often because there are high thresholds for access to their services, preventing often the most effective treatment of mental health conditions - early intervention.

Guidance for commissioners of psychiatric intensive care units (PICU). This guidance was produced in partnership with the National Association of Psychiatric Intensive Care and Low Secure Units (NAPICU) to support the commissioning of high-quality PICUs and improve patient experience. It seeks to empower and enable commissioners, managers and clinicians to jointly develop high quality PICUs. It provides summary guidance which will assist commissioners to meet the needs of their local population, and achieve the ambitions of the Five Year Forward View focusing on patient safety, clinical effectiveness and patient experience.

News

No difference in patient mortality for weekend vs weekday admissions to psychiatric hospitals. Interim findings from a NIHR HS&DR study, published in The Lancet, have found that there is no significant difference in risk of mortality for patients admitted to a psychiatric hospital at the weekend versus during the week.  

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

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Primary Care

Publications/guidance

General Practice forward view. NHS England has published a General Practice Forward View that sets out a multi-billion plan designed to get general practice back on its feet, improve patient care and access, and invest in new ways of providing primary care. It contains specific, practical and funded steps on investment, workforce, workload, infrastructure and care redesign. It includes: recurrent funding to increase by an estimated £2.4bn pa by 2020/21; doubling the growth rate in GPs through new incentives for training, recruitment, retention and return to practice; a new practice resilience programme to support struggling practices; legal limits on administrative burdens at the hospital/GP interface; support for individual practices and for federations and super-partnerships; direct funding for improved in hours and out of hours access, including clinical hubs and reformed urgent care; and a new voluntary contract supporting integrated primary and community health services.

Who cares? The future of general practice. This paper from the think-tank Reform argues that it is crucial to revolutionise the way general practice operates in England. Care should be delivered by larger providers, capable of offering a range of extended services, such as diagnostics, urgent care or minor surgery, seven days a week. This entails a more diverse workforce, with less of an emphasis on the GP, and a greater use of technology, particularly for the interaction between patients and clinicians.

Primary care. This report from the House of Commons Health Committee analyses the challenges facing primary care and examines the long-term solutions which can improve access to services and patient care. It warns that primary care is under unprecedented strain and struggling to keep pace with relentlessly rising demand. It concludes that primary care has to be able to change - it needs to allow for longer appointments and for people to be cared for by a wider range of professionals. The priority for Government should be to train, develop and retain not only more GPs but wider multi-disciplinary teams working within a more integrated system of care. While improving access to primary care is a welcome goal, practical application of the seven day policy should be locally designed, led by the evidence and take account of local recruitment challenges. The policy must also focus on the continuity of patient care and avoid reducing the capacity of weekday services as well as urgent out of hours primary care cover.

Digital requirements for new primary care models. This Nuffield Trust briefing looks at emerging changes in primary care, and how digital technology can help managers and clinicians to deliver them.

Digital requirements for new primary care models. This Nuffield Trust briefing looks at emerging changes in primary care, and how digital technology can help managers and clinicians to deliver them.

Framework for patient and public participation in primary care commissioning. Guide for primary care commissioners in NHS England and CCGs on how to involve patients and the public in the commissioning of primary care services. 'Patients and the public' includes service users and carers, and participation in primary care commissioning refers to how people are involved in planning (including policy making and relevant programmes), buying and monitoring primary care services. 'Primary care' includes general practice, community pharmacy, dental, and optometry (eye health) services.
There is also information for patients and the public on How to get involved in primary care commissioning

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

Tackling poor oral health in children: local government's public health role. Commissioning responsibilities of the Healthy Child Programme for 0-5 year olds were transferred to local government in October 2015. This included the commissioning of Health Visitors who lead and support delivery of preventive programmes for infants and children including providing advice on oral health and on breastfeeding and reducing the risk of tooth decay. This updated LGA publication looks at local authorities' role and includes a number of case studies.

Healthy Lives, Healthy People – A review of the 2013 public health workforce strategy. Details progress made with the Strategy, which sets out actions for various partners in the new public health system to support and develop the public health workforce. The Strategy aims to help embed public health capacity within the wider workforce to support delivery of the Public Health Outcomes Framework.

Good public health practice framework 2016. This revised non-statutory guidance from the Faculty of Public Health provides the basis for good professional practice in public health. It applies to all members of the core public health workforce, including public health practitioners and specialists and those training to become practitioners and specialists.

Good public health practice framework 2016. This guidance is aimed at all specialists and practitioners from all professional backgrounds and aims to provide a basis for good professional practice in public health. It also aims to inform the planning of continuing professional development activities, appraisal and revalidation.

2016/17 Vaccination and immunisation programmes agreement. Summary of changes that have been agreed to the vaccination and immunisation programmes that are commissioned for delivery by general practice. This includes those which are legally directed by the Secretary of State for Health to establish or offer, and those NHS England has prescribed. The requirements for these two new programmes will be outlined in the NHS England service specifications which will be published by NHS England in due course. The detail of these programmes will be available in the vaccination and immunisation programmes 2016/17 guidance and audit requirements document, which will be published in due course.  

If you wish to discuss any queries you may have around public health please contact Claire Bentley.  

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Regulation

Publications/Guidance

CQC review of how NHS trusts investigate and learn from deaths. Following the Government's response to a report into deaths of persons with mental health problems in contact with Southern Health Foundations NHS foundation trust, the Care Quality Commission (CQC) is to carry out a review of the quality of practice by NHS trusts when investigating such deaths. The review will also focus on how trusts can learn from the deaths of those with learning disabilities and mental health issues.

Consultations

The Nursing and Midwifery Council - amendments to modernise midwifery regulation and improve the effectiveness and efficiency of fitness to practise processes. Seeks views on a draft Amendment Order making changes to the Nursing and Midwifery Order 2001 that will: remove statutory midwifery supervision provisions, which will result in a clear separation of the roles and purpose of the supervision and regulation of midwives; remove the statutory Midwifery Committee from the NMC’s governance structures; and make improvements to the NMC’s fitness to practise processes to enable further improvements and deal with cases in a more appropriate manner. The consultation closes on 17 June 2016.

Consultation on standards for pharmacy professionals. The General Pharmaceutical Council is seeking views on core standards that every pharmacist, pharmacy technician, pharmacy student and trainee will be expected to meet. The nine core standards describe the attitudes and behaviours that contribute most to safe and effective care. The closing date for responses is 27 June 2016.

News 

CQC announces changes in regulatory fees for providers. The Care Quality Commission has outlined the fees that providers of health and adult social care in England will pay from April 2016 to cover the costs of their regulation.

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

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General

Publications/Guidance

Emergency general surgery: challenges and opportunities. The Nuffield Trust was commissioned by the Royal College of Surgeons of England to explore the challenges facing emergency general surgery and identify opportunities to overcome them. The report found that the most significant challenges faced by emergency general surgery (EGS) include variation in outcomes, workforce, organisational and operational issues and underlying demographic and epidemiological trends. The report argues that the quickest gains could be achieved through the systematic use of protocols and pathways. The most comprehensive means to address the challenges faced by EGS would be the development of managed clinical networks. 

NHS England Enhanced Service Specifications 2016/17. NHS England has published enhanced service specifications for vaccination programmes and avoiding unplanned admissions. The service specifications have been updated to reflect the 2016/17 contract changes.

Privatisation and independent sector provision of NHS healthcare. The BMA's first report on privatisation in the health service argues that the independent sector should be subject to the same robust standards as NHS providers and managers must be wary of the health service becoming fragmented. The report calls for Government and health bosses to implement a series of recommendations aimed at protecting the NHS from being destabilised. It also urges commissioners and health chiefs to consider the possible negative effects of privatisation on training and recruitment and says the taxpayer must not be saddled with the costly legacy of private firms leaving contracts, as was the case at Hinchingbrooke Hospital in Cambridgeshire.

Summary of changes made to the way the NHS charges overseas visitors for NHS hospital care. Updated guide that now notes changes to the health surcharge which came into force on 6 April 2016.

Tackling the growing crisis in the NHS: an agenda for action. The King's Fund has identified three big challenges for the NHS in England: sustaining existing services and standards of care; developing new and better models of care; and tackling these challenges by reforming the NHS 'from within'. Drawing on its work and a lecture given by Chris Ham to the Cambridge Whitehall Group in December, this briefing offers some practical solutions to help the NHS address one of the biggest crises in its history. They represent the essential actions needed to ensure that the NHS and social care can be both sustained and transformed.

NHS Outcomes Framework 2016 to 2017 at-a-glance. Sets out the framework and indicators that will be used to hold NHS England to account for improvements in health outcomes. 

Multi-agency statutory guidance on female genital mutilation (FGM). These multi-agency guidelines on FGM are aimed at those with statutory duties to safeguard children and vulnerable adults. It supersedes the previous guidance issued in 2014, 'Female genital mutilation: guidelines to protect women and children'.

NHS England Business Plan 2016-2017. Sets out NHS England's 10 business priorities for the coming year, reflecting the main themes of the government mandate. It details how they will improve health and secure high quality healthcare for the people of England, now and for future generations. The priorities are grouped under three themes that embody the agenda of the Five Year Forward View: improving health, transforming care and controlling costs.

Final report of the Mutuals in Health Pathfinder programme. The objectives of the Mutuals in Health programme were to support interested organisations to explore how a mutual model might increase staff engagement. This report summarises the findings from the programme and draws out lessons for the future of mutuals in health and care. In so doing, it highlights significant barriers that need to be removed if mutualisation in health is to be extended beyond the community health and social care providers who have already gone down this route.

The Hospital Food Standards Panel’s report on standards for food and drink in NHS hospitals. This report recommends a set of food standards that should become routine practice across NHS Hospitals. The report looks at standards relating to patient nutrition and hydration, healthier eating across hospitals and sustainable food and catering services. NHS adoption of the recommended standards will be required through the NHS contract meaning that hospitals will have a legal duty to comply with the recommendations. There is also a toolkit that can be used to help NHS organisations develop and maintain a hospital food and drink strategy as recommended in the Panel's report.

A guide to property costs. From 1 April 2016, NHS Property Services is changing the way it charges tenants, CCGs and NHS Trusts for property costs and the way it invoices them. The main change is a move to market-based rental charging on all freehold properties. This guide sets out changes that take effect from the beginning of the 2016/17 financial year and what customers can expect to see when they receive their invoices. There is also a letter from Pat Mills, Commercial Director at the DH, that sets out the background on the move to market rentals along with the reimbursement arrangements.

Catalyst or distraction? The evolution of devolution in the English NHS. While recent interest in devolution within England has not specifically focused on health care, eight local Devolution Deals that include aspects of health care have been agreed or announced in 2015 and the first part of 2016 alone. Focusing primarily on devolution in the NHS, the report considers the potential implications for health and care outcomes in England and how policy could best evolve. It draws on analysis of the Devolution Deals agreed to date, relevant literature, and international experience with a focus on four European decentralised health systems.

Consultations

Consultation on the draft statutory multi-agency practice guidance on Female Genital Mutilation (FGM). A Home Office publication summarises responses to the consultation on the draft statutory multi-agency practice guidance on female genital mutilation (FGM), and states that the Government has taken the responses into account in developing the final version of the guidance. It adds that the Government is clear that placing the guidelines on a statutory footing will support a more effective front-line response to FGM.  

News

HSCIC changing its name to NHS Digital. Announces that from July 2016, the Health and Social Care Information Centre (HSCIC) will change its name to NHS Digital, building on the role it plays in directly supporting the NHS and social care services. Noel Gordon has been appointed as the new Chair for NHS Digital by the Secretary of State. 

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

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