Health and Social Care Update - January 2018

Policy and law relevant to those involved in health and social care work.

04/01/2018

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. 

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Training Events

Inquests

Acute and emergency care

Mental Health

Children

Primary Care

Clinical Risk/Patient Safety

Procurement

Commissioning

Providers

Employment/HR

Public Health

Health and Safety

Regulation

Independent Healthcare

Social care 

Information sharing/data

General  

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Bevan Brittan Free Training Events

Clinical Risk Webinars

Bevan Brittan Clinical Risk/Medical Law Training - These are internal hour long lunch time training sessions that are attended by our team of solicitors. If you are a client and would like to come along and join our team at these sessions just ask Claire Bentley.

You can attend in our London, Bristol or Birmingham office. If you are unable to get to one of our offices you can also sign up to watch the training sessions remotely via our webinar facility. The  lunchtime training sessions coming up are:-  

  • Tuesday 16 January 12.30 - 2pm Fatal Accidents Claims Update
  • Tuesday 30 January 12.30 - 2pm Sussex Community NHS FT –v- Price, and a review of bed-blocking.  

In addition to our free training programme, we also provide bespoke knowledge transfer sessions on a range of healthcare law topics. If you wish to discuss any queries you may have around training or webinars please contact Claire Bentley.  

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Acute and emergency care

Publications/guidance 

Framework for maximising the use of care homes and use of therapy-led units for patients medically fit for discharge. This best practice framework aims to address two models and the implementation approach that needs to be taken by sustainability and transformation partnerships (STPs) and their provider organisations with ensuing threats to patient safety, during the winter months. It includes case studies of how nursing and care staff help lead the way in improving services during winter, which provide examples of practice to reduce delayed transfers of care, as well as optimising pathways for patients who are medically ready for discharge.

Admissions of inequality: emergency hospital use for children and young people. This briefing looks at the relationship between deprivation and the use of emergency hospital care by children and young people in England. It aims to describe and highlight areas of inequality and to explore how they have changed over time. As well as looking at the overall patterns of emergency hospital use, it focuses in particular on three common conditions – asthma, diabetes and epilepsy – where more timely and effective primary, community or outpatient care could prevent admissions. 

The final injustice: Variation in end of life care in England. This report by Macmillan, the cancer charity, says that more rapid progress must be made towards delivering the Government’s national commitment to improve end of life care and ensure everyone’s choices on where they spend their last weeks and days are respected. Its analysis of people who died from cancer in 2015 demonstrates an 'unacceptable gulf' between the experiences of cancer patients in England, with factors such as deprivation affecting whether a person receives the right care and choice when they die. The charity calls on the Government and regional health leaders to end this variation and make sure everyone has access to the right care and support when they die.

What’s going on with A&E waiting times? Waiting times in accident and emergency (A&E) departments are a key measure of how the NHS is performing, and they generate significant interest. Here, the King's Fund looks at why patients have been waiting longer in A&E in recent years.

Ready and resilient? How NHS trusts have prepared for winter. This NHS Providers briefing says that NHS trusts have done all they can to prepare for extra winter pressures. Local and national planning for winter is more extensive and meticulous than ever before, but the health service may be sorely tested in the coming months as it is already at or close to full stretch. Trusts are working hard to minimise the risks for patients. The briefing outlines in detail what has been done locally and nationally to ensure safe, high quality care for patients.  

News 

NHS to consider routine use of ‘drunk tanks’ to ease pressure on A&Es. The NHS England Chief Executive Simon Stevens has announced that the NHS will decide this year whether "drunk tanks" should routinely be used take pressure off hard-pressed A&E departments and 999 ambulance services during the seasonal holiday period. Experience over the coming 2017/18 New Year would help determine whether the schemes would be rolled out to major towns and cities during 2018. Scaling up their use could help emergency services cope with seasonal pressures next year.

Electronic prescribing to be piloted in integrated urgent care. NHS Digital has announced trials of the electronic prescription service (EPS) in integrated urgent care settings. This will mean that patients seeking care out of hours or in urgent care settings can have their prescriptions sent directly to a pharmacy of their choice, rather than relying on paper prescriptions. 

NHS cancels surgery for tens of thousands to avoid winter crisis. Hospital chiefs are told by NHS England to take drastic action, including setting up makeshift wards. 

If you wish to discuss any queries you may have around acute and emergency care please contact Claire Bentley.  

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Children

Publications/guidance 

Working with schools to improve the health of school-aged children. England’s Chief Medical Officer has highlighted the "concerning" levels of obesity and mental health problems being seen among the young and has said that the health of children needs to become more of a priority. This LGA report showcases the work being down by schools and local authorities across the country to improve the health of children.  

Mental health services for post-16 students in England. This briefing paper gives an outline of recent studies on the mental health of students, government mental health policy for students, support in further and higher education providers, the legal duties of providers and discusses issues raised. It finds that young adults aged 16–24 today are more likely than previous generations of young adults to experience mental health issues and the numbers of students reporting mental ill health is increasing.  

Admissions of inequality: emergency hospital use for children and young people. This briefing looks at the relationship between deprivation and the use of emergency hospital care by children and young people in England. It aims to describe and highlight areas of inequality and to explore how they have changed over time. As well as looking at the overall patterns of emergency hospital use, it focuses in particular on three common conditions – asthma, diabetes and epilepsy – where more timely and effective primary, community or outpatient care could prevent admissions. 

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

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Clinical Risk/Patient Safety

Publications/Guidance  

The 93rd Update on Practice Direction Amendments introduced a change in the rules as to concurrent evidence from experts. This gives the trial judge a considerable degree of flexibility about the way in which expert evidence is heard. These rules came into force on 22 November 2017.  

Breast screening: interval cancers and duty of candour toolkit. This national guidance provides advice to health professionals about how to communicate information on interval cancers to women who were previously screened in the programme. 

Implementing better births: continuity of carer. This guidance sets out how local maternity systems can improve their services so that women experience continuity in the professionals providing their maternity care. 

Cases  

Right to be informed - Raul Guiu Gallardo v Imperial College Healthcare NHS Trust. [2017] EWHC 3147 (QB) A patient had the right to be informed of the outcome of any treatment, the prognosis, and the options for follow-up care and treatment as soon as they were well enough to participate in the discussion although there was flexibility as to timings. A patient who only learnt of the true nature of his condition nine years after an operation for the removal of a tumour, which was found to be malignant was awarded general damages. The patient had also not been advised of the risk of recurrence and the need for regular monitoring and scans.

Discount - Porter v Barts Health NHS Trust [2017] EWHC 3205 (QB).This judgment in this case looks at the problems caused to personal injury claimants by the change in the discount rate.

Getting an adjournment because of sickness. Mulalley and Company Ltd v Regent Building Services Ltd [2017] EWHC 2962 sets out the relevant principles relating to illness.   

News  

New approach to NHS clinical assessment could save thousands of lives. NHS England is asking every hospital trust to adopt the Royal College of Physicians’ new clinical assessment system National Early Warning Score (NEWS) that was developed by the Royal College of Physicians with the aim of creating a standardised approach to clinical assessment across the country. The system assesses patients on a series of key measures and the results are plotted on a NEWS chart which then gives a score for each measure and the combined number then shows the level of clinical care needed and the risk of deterioration. It is estimated that the NEWS is now being used in over 70% of trusts but NHS England is setting the goal of having the system in place across every acute and ambulance setting by 2019. 

Bevan Brittan Updates

Are the stars aligning for clinical negligence cost reform? The publication of  the Public Accounts Committee (PAC) report on managing the costs of clinical negligence represents an important moment in this difficult and ongoing area. The PAC have brought the issue firmly onto their watch and it is clear that they are determined to see action, with various bodies required to supply progress reports at specific points. Are the stars aligning for significant reform?

Webinars  

Bevan Brittan Clinical Risk/Medical Law Training - These are internal hour long lunch time training sessions that are attended by our team of solicitors. If you are a client and would like to come along and join our team at these sessions just ask Claire Bentley. You can attend in our London, Bristol or Birmingham office. If you are unable to get to one of our offices you can also sign up to watch the training sessions remotely via our webinar facility. The  lunchtime training sessions coming up are:-  

  • Tuesday 16 January 12.30 - 2pm Fatal Accidents Claims Update
  • Tuesday 30 January 12.30 - 2pm Sussex Community NHS FT –v- Price, and a review of bed-blocking  

If you wish to discuss any clinical risk or patient safety issues please contact Joanna Lloyd, Catherine Radford or Penelope Radcliffe

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Commissioning  

Publications/Guidance  

Challenging health inequalities: Support for CCGs. This NHS England guide has been created to help identify areas of variation in emergency admissions in more and less deprived CCGs and to promote a discussion where variation occurs.

Making strategic commissioning work: lessons from home and away. With the move towards accountable care, clinical commissioners are starting to take on a more strategic role. This report aims to support commissioners in these new functions by outlining best practice from health systems around the world that are developing policy around new care models and place-based systems of care. 

Consultations

Conditions for which over the counter items should not routinely be prescribed in primary care: A consultation on guidance for CCGs. NHS England is seeking views on proposals to reduce prescribing of over-the-counter medicines for 33 minor, short-term health concerns. The intention is to produce a consistent, national framework for CCGs to use. Subject to the outcome of the consultation, the commissioning guidance will need to be taken into account by CCGs in adopting or amending their own local guidance to GPs in primary care. The consultation closes on 14 March 2018.   

News 

NHS to join forces with major developers to build a healthy national future. NHS England is calling on the country’s top housing developers to apply the lessons from the first Healthy New Towns schemes by creating a national network that will put healthy living at the heart of future home building. There are 10 sites taking part in the first healthy Towns scheme, covering 60,000 new homes. Ideas so far include safe play areas for children, one-stop health hubs and digitally monitored fitness programmes to get everyone exercising. In January 2018, NHS England will be inviting applications for housing developers and associations to join a national network that will help improve the health of the nation.

NHS England announces new specialised treatments for patients. NHS England has announced the results of the first of two prioritisation rounds to decide which new specialised commissioning treatments and services will be made available for patients for the 2018/19 financial year. It has approved an initial three new treatments and services for funding: a treatment for HIV, a new specialised service for adults with primary ciliary dyskinesia (a genetic disorder affecting the respiratory system) and a new specialised service for Stevens-Johnson syndrome, a serious disorder of the skin. Funding for the new treatments and services will begin from April 2018.  

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

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Employment/HR 

Publications/guidance 

NHS workforce race equality standard: 2017 data analysis report for NHS trusts This report analyses the data on race equality in the NHS workforce and finds steady improvements in some areas. The number of black and minority ethnic (BME) senior managers has increased by 18 per cent and there has been an increase in the number of NHS trusts with more than one BME board member. However, the analysis finds that BME members of staff are more likely to experience discrimination at work and within the recruitment process.   

Enabling BME nurse and midwife progression into senior leadership positions. This report summarises the learning from engagement work that identified what the best-performing trusts in the workforce race equality standard area were doing, and includes examples that outline best practice approaches and a number of suggested actions to support improvement. 

Facing the facts, shaping the future: A health and care workforce strategy for England to 2027. This draft strategy takes an uncompromising look at the challenges faced by the health and care system, charting the growth in the NHS workforce over the last five years while setting out the critical workforce challenges that will be faced over the next decade. It proposes a range of measures to improve productivity, boost training and retention, open up new routes into nursing and prepare the future workforce for technological advances such as genomics, artificial intelligence and digital robotics, which are poised to transform modern medicine. The closing date for comments is 23 March 2018.

The state of medical education and practice in the UK: 2017 report. This GMC report gives an overview of issues that feature prominently in healthcare. It examines the GMC data relating to the changing medical register and explores the patterns of complaints about different groups of doctors. The report identifies a raft of challenges facing the medical profession today against a backdrop of an increasing and older population, and highlights four priorities for the UK’s governments and agencies responsible for medical training and workforce planning. In particular, it notes that the supply of new doctors into the UK’s medical workforce has failed to keep pace with changes in demand.

Retaining your clinical staff: a practical improvement resource This improvement resource outlines key steps to improving retention of clinical staff. The advice is taken from interviews with trust HR directors, directors of nursing and medical directors.  

Bevan Brittan Updates

Employment Eye December 2017

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

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Health and Safety 

Cases  

R v Shrewsbury and Telford NHS Trust: Sentencing remarks of Mr Justice Haddon-Cave. Shrewsbury and Telford Hospital NHS Trust was fined £333,333 and ordered to pay £130,000 costs by Stafford Crown Court, after it pleaded guilty to breaching s.3(1) of the Health and Safety at Work Act 1974. The prosecution resulted from a series of HSE investigations into the deaths of five elderly patients, who sustained fatal injuries as result of falling while being cared for in hospitals run by the Trust. The HSE investigations found that fall prevention measures, including close supervision of those in a confused mental state, were not properly applied. This was made worse by poor consideration and communication surrounding measures to protect against falls arising from each patient’s particular frailties. In his judgment, Mr Justice Haddon-Cave discusses the courts' approach when sentencing large organisations for breach of health and safety legislation. He analysed the cases, applying the tests of: Culpability; Harm; Significant cause of harm; Aggravating and mitigating features; and Financial consequences. He then determined that proper starting level of fine in this case if the defendant had been a private commercial organisation would have been £1m. This was reduced by a third for the Trust's early plea and he then reduced this figure by 50% to reflect the Trust’s financial circumstances and that it was public health care body, resulting in a net fine of £333,333.  

If you wish to discuss any health and safety issues raised in this section please contact Debbie Rookes.  

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Independent Healthcare 

Independent doctors to be rated by the Care Quality Commission. For the first time, all healthcare organisations in England that offer regulated care will be rated by the Care Quality Commission (CQC). Organisations will have to display their inspection ratings so patients can clearly see safety standards. The CQC’s current ratings programme – which covers hospital care, social care and GPs – will be extended to include more than 800 additional providers. This includes independent doctors that offer primary care online. The CQC will require providers affected by these changes to publicly display their rating, for instance on their website or business premises. This will allow patients to make an informed choice when deciding which care service they want to use. The ratings scheme has been ‘future-proofed’ to cover services that may develop in the future. It will ensure that new services are also given a rating.  

If you wish to discuss any queries you may have around independent healthcare please contact Vincent Buscemi.   

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Information Sharing/data  

Publications/Guidance 

National Data Guardian for Health and Care 2017 report: impact and influence for patients and service users. This report looks back over the past three years since the creation of the National Data Guardian role and describes future priorities. It sets out a case for the independent advice and challenges that the role provides to ensure that confidential data collected by the NHS and social care services is safeguarded and used appropriately to improve care.   

Changes to data protection requirements under the General Data Protection Regulations (GDPR). NHS Employers has developed a factsheet to help employers understand and prepare for the upcoming data protection changes under GDPR, which come into force on 25 May 2018. It includes a summary of the key changes, detail on data protection principles and terminology, and important steps which HR departments can take to prepare.  

If you wish to discuss any issues raised in this section please contact Jane Bennett.  

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Inquests 

Mental health in prisons: Eighth Report of Session 2017-19. A Committee of Public Accounts report states that record levels of self-inflicted deaths and self-harm in prisons are a "damning indictment" of the current state of the mental health of those in custody. It argues that the Government does not have reliable or up-to-date measure of the number of prisoners who have mental health problems, and claims that existing screening procedures are insufficient to adequately identify those who need support and treatment.  

If you wish to discuss any queries you may have around inquests please contact Will Pickles.   

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Mental Health

Publications/Guidance 

Innovation in housing, care and support. This briefing makes the case for collaboration between health and housing organisations in order to improve patient outcomes while relieving pressure on mental health services. It contains four case studies on innovative support and care services delivered through collaborations between housing and health care providers.

Mental health in prisons: Eighth Report of Session 2017-19. A Committee of Public Accounts report states that record levels of self-inflicted deaths and self-harm in prisons are a "damning indictment" of the current state of the mental health of those in custody. It argues that the Government does not have reliable or up-to-date measure of the number of prisoners who have mental health problems, and claims that existing screening procedures are insufficient to adequately identify those who need support and treatment.

Ignoring the alarms: how NHS eating disorder services are failing patients. This report from the Parliamentary and Health Service Ombudsman reviews complaints about the care of patients with eating disorders. It concludes that inadequate care coordination and planning have led to failures in patient care. It makes recommendations for improvements in medical education and training to improve understanding of eating disorders and for improvements in provision and access to services.

A framework for mental health research. This framework provides a collective view of how mental health research should develop in the UK over the next decade. It sets out a structure to improve co-ordination and strengthen the focus on areas where mental health research is likely to translate into significant health benefit.

Mental health services for post-16 students in England. This briefing paper gives an outline of recent studies on the mental health of students, government mental health policy for students, support in further and higher education providers, the legal duties of providers and discusses issues raised. It finds that young adults aged 16–24 today are more likely than previous generations of young adults to experience mental health issues and the numbers of students reporting mental ill health is increasing.

A focus on restrictive intervention reduction programmes in inpatient mental health services. Highlights good practice by NHS mental health services that has led to reduction in number of times that staff have needed to use physical restraint in these circumstances.  

Consultations 

Decision making and mental capacity: Draft guidance consultation. NICE has written some guidance about decision making and mental capacity. This draft guidance recommends that health and social care professionals should support people to overcome any difficulties they may face when making decisions. It advises that staff should take a neutral stance on any decisions and that using visual aids or involving family members can help with decision making for those with diminished mental capacity. NICE will be accepting comments and feedback on this draft guidance until 5 February 2018. 

News

Measures to cut the use of police cells as places of safety came into force on 11 December 2017. The mental health provisions will mean it will no longer be possible to place children (under 18s) experiencing a mental health crisis in a police cell. For adults, the use of police cells as places of safety will be significantly restricted and it will only be possible for them to be used in exceptional circumstances. The period for which a person can be detained for the purpose of a mental health assessment will also be cut to 24 hours. 

Bevan Brittan Updates 

D v Ministry of Defence (by his litigation friend, the Official Solicitor) (Medical Treatment) [2017] EWCOP 15. This case will be of interest to commissioners and providers when considering requests for unapproved or experimental treatment unavailable through the NHS.  The case has echoes of the Charlie Gard case but had a very different outcome, the Court commenting that "all life is an experiment".

Court of Protection Rules and Practice Direction Changes. From 1 December 2017 the new Court of Protection Rules 2017 and Court of Protection Practice Directions 2017 came into force. These incorporate the previous pilots (transparency, case management and s.49 reports) and bring the CoP Rules into line with the CPR. The vast majority of CoP Rules and PD now have a different number. 

Clinical Risk Webinars  

Bevan Brittan Clinical Risk/Medical Law Training - These are internal hour long lunch time training sessions that are attended by our team of solicitors. If you are a client and would like to come along and join our team at these sessions just ask Claire Bentley. You can attend in our London, Bristol or Birmingham office. If you are unable to get to one of our offices you can also sign up to watch the training sessions remotely via our webinar facility. The  lunchtime training sessions coming up are:-  

  • Tuesday 16 January 12.30 - 2pm Fatal Accidents Claims Update
  • Tuesday 30 January 12.30 - 2pm Sussex Community NHS FT –v- Price, and a review of bed-blocking.  

Bevan Brittan Mental Health Extranet

Would you like to access the Bevan Brittan Mental Health Extranet? - It is a secure online resource containing a discussion forum, knowledge bank and information about training events. If you would like access please contact Claire Bentley.  

If you wish to discuss any mental health issues please contact Simon Lindsay or Stuart Marchant.  

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Primary Care 

Publications/Guidance 

Conditions for which over the counter items should not routinely be prescribed in primary care: A consultation on guidance for CCGs. NHS England is seeking views on proposals to reduce prescribing of over-the-counter medicines for 33 minor, short-term health concerns. The intention is to produce a consistent, national framework for CCGs to use. Subject to the outcome of the consultation, the commissioning guidance will need to be taken into account by CCGs in adopting or amending their own local guidance to GPs in primary care. The consultation closes on 14 March 2018.   

A GP’s diary of quality improvement. This video case study shows how a GP has the opportunity to hold a session on quality improvement, in the lead up to a CCG monthly meeting. Her surgery is part of a cluster that is considering becoming a Primary Care Home pilot. Using the Change Model from the General Practice Improvement Leaders programme, a programme that is part of the support available through the General Practice Forward View, she hopes the session will develop a 'shared purpose' that will enable the cluster to decide whether or not to opt-in to the Primary Care Home pilot. 

If you wish to discuss any queries you may have around primary care please contact Vincent Buscemi

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Procurement 

Publications/Guidance 

Procurement Policy Note 04/17 New threshold levels 2018. This PPN sets out the new threshold levels to apply for the purposes of the Public Contracts Regulations, from 1 January 2018. For a short summary of the main thresholds, see Bevan Brittan's Alert EU procurement thresholds for the public sector

If you wish to discuss any queries you may have around procurement please contact Vincent Buscemi.   

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Providers 

Publications/Guidance 

Guidance on implementing the overseas visitor charging regulations. Updated guidance for NHS bodies who need to charge overseas visitors for NHS hospital treatment, under the NHS (Charges to Overseas Visitors) Regulations 2017. The guidance should be used alongside the regulations and any additional legal advice. 

Breast screening: women wanting to attend service out of area. Guidance for breast screening providers on the screening of women at a different NHS breast screening unit from the one the screening provider invites her to attend - 'out-of-area screening'.

Shaping pharmacy for the future: Hospital Pharmacy – A briefing for members in England. RPS England’s new briefing provides a summary of the major activities affecting pharmacists with key points to help clarify what’s going on and what it means for them. The briefing sets out how the focus uniting the changes is the value pharmacists bring when carrying out clinical functions as part of the multidisciplinary team in support of medicines optimisation and the care of patients. There is a drive towards reducing the amount of resource devoted to infrastructure services across the initiatives. 

If you wish to discuss any queries you may have around providers please contact Vincent Buscemi.   

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Public Health 

Publications/Guidance 

Approach to surveillance. This guide focuses on the need for high quality evidence from PHE's surveillance systems to ensure that it has the right information available at the right time to inform public health decisions and actions. It sets out how strategies can be developed for surveillance of both infectious and non-communicable diseases.

Making obesity everybody’s business: A whole systems approach to obesity. This LGA briefing, written in partnership with Public Health England and the Association of Directors of Public Health, focuses on the Whole Systems Obesity programme, which will provide local authorities with a different approach to tackling obesity. The programme is exploring the evidence and local practice to develop guidance and tools to help councils set up a whole systems approach to obesity in their local area. This involves the whole local system of stakeholders, recognising that it is a problem that goes far beyond public health. It makes tackling obesity everybody’s business.

Public involvement in alcohol research. This report from Alcohol Research UK sets out some of the key principles behind greater public involvement in their field. It also explores the key challenges and describes how it feels that researchers might better engage with the public in future.

Active people, healthy places. This LGA report shares good practice and helps decision-makers consider how their council can deliver on this agenda in the best way for local people and communities.

Working with schools to improve the health of school-aged children. England’s Chief Medical Officer has highlighted the "concerning" levels of obesity and mental health problems being seen among the young and has said that the health of children needs to become more of a priority. This LGA report showcases the work being down by schools and local authorities across the country to improve the health of children.  

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

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Regulation 

Legislation

Blood Safety and Quality (Amendment) Regulations 2017 (SI 2017/1320). These regulations, which come into force on 15 February 2018, amend SI 2005/50 so as to implement EU Directive 2016/1214 which requires Member States to ensure that blood establishments and blood banks use good practice guidelines to interpret the standards and specifications set out in Commission Directive 2005/62 and take into account the Good Practice Guidelines.

Ionising Radiation (Medical Exposure) Regulations 2017 (SI 2017/1322). These regulations, which come into force on 6 February 2018, transpose and implement the medical exposures aspects of Directive 2013/59/EURATOM to ensure safe use of radiological procedures such as medical imaging or radiological treatments.

Cases 

General Medical Council v Somuah-Boateng (Unreported, 2017) (Admin Ct). The court held that the Medical Practitioners' Tribunal had erred in only suspending a doctor who had entered into a sexual relationship with a vulnerable former patient, telling her that sexual intercourse would be good for her medical condition. The appropriate sanction to protect the public and maintain the reputation of the medical profession was erasure from the register.

Professional Standards Authority for Health & Social Care v (1) Nursing & Midwifery Council (2) Apeaning (Unreported, 2017) (Admin Ct). The Nursing and Midwifery Council had been wrong to find that a senior nurse's fitness to practise had not been impaired by misconduct and lack of insight into his behaviour. While caring for psychiatric patients he had behaved inappropriately and breached protocol and codes of practice, demonstrating a complete lack of compassion and care which was wholly inconsistent with the nursing profession. 

Consultations

Promoting professionalism, reforming regulation. The DH is seeking views on proposals to reform the regulation system for healthcare professionals in the UK. The proposed model of professional regulation will secure public trust, improve clinical practice and adapt to developments in healthcare. The consultation closes on 23 January 2018.   

News

Independent doctors to be rated by the Care Quality Commission. For the first time, all healthcare organisations in England that offer regulated care will be rated by the Care Quality Commission (CQC). Organisations will have to display their inspection ratings so patients can clearly see safety standards. The CQC’s current ratings programme – which covers hospital care, social care and GPs – will be extended to include more than 800 additional providers. This includes independent doctors that offer primary care online. The CQC will require providers affected by these changes to publicly display their rating, for instance on their website or business premises. This will allow patients to make an informed choice when deciding which care service they want to use. The ratings scheme has been ‘future-proofed’ to cover services that may develop in the future. It will ensure that new services are also given a rating.

GPhC Council gives green light to implementation of revalidation in a ‘step-change’ for pharmacy professionals. Announces that the General Pharmaceutical Council will introduce revalidation for pharmacy professionals from 30 March 2018, after its Council approved the framework for revalidation and agreed the timetable for its implementation.

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

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Social Care 

Publications/Guidance 

Enhanced health in care homes: learning from experiences so far. This King's Fund report shares learning from diverse areas about how people working in care homes, health services, local authorities and CCGs experience the process of working together more closely. It focuses on what they have actually done to put the high-level aim of closer partnership working into practice.

A good retirement: public attitudes to the role of the state and the individual in achieving financial security in later life. This research shows that more than 57 per cent of the public believe that the individual has greater responsibility than the government in meeting the costs of their care. The research reveals that there is a gap between citizens’ expectations and the realities of the preparations they will be able to make for their futures.

Doing care differently. This report sets out a summary of what needs to be considered to deliver a social care funding solution for now and the future. It examines six key areas of the social care reform agenda: demand, funding and responsibility, quality, integrated care, technology, and sustainability and value for money.  

Framework for maximising the use of care homes and use of therapy-led units for patients medically fit for discharge. This best practice framework considers two models for ensuring patients do not spend any longer than they need to in hospital and the implementation approach that needs to be taken by STPs and their provider organisations during the winter months. 

Innovation in housing, care and support. This briefing, produced by the NHS Confederation in partnership with Mental Health Network members contains four case studies on innovative support and care services delivered through collaborations between housing and health care providers.

Combatting loneliness one conversation at a time: a call to action This report outlines the findings of the Commission and how loneliness affects different groups of people within society. The report highlights the range of people affected by loneliness and shows how tackling loneliness can benefit individuals and communities.  

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

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General 

Publications/Guidance 

Reducing modern slavery. This report from the National Audit Office states that until the government is able to establish effective oversight of the modern slavery system as a whole, it will not be able to significantly reduce the prevalence of modern slavery or show that it is achieving value for money.

Department of Health: gender pay gap report and data 2017. A Cabinet Office report details its gender pay gap data, which includes figures for Government special advisers, for the period 1 April 2016 - 31 March 2017. It outlines the progress made by the Cabinet Office in: improving the diversity of the Senior Civil Servants; having diverse recruitment panels for all campaigns; and advertising all roles externally by default to attract the broadest pool of applicants. Data on the difference in employees’ average earnings from April 2016 to March 2017. 

Clinically assisted nutrition and hydration (CANH). Decisions to withdraw clinically assisted nutrition and hydration (CANH) from patients in permanent vegetative state (PVS) or minimally conscious state (MCS) following sudden onset profound brain injury. Interim guidance for health professionals in England and Wales from the BMA, Royal College of Physicians (RCP) and General Medical Council (GMC).

Locked up, locked out: health and human rights in immigration detention. This report outlines how aspects of current detention policies and practices, such as no clear time-limits on how long people will be detained, are detrimental to the health of migrants and asylum-seekers, and sets out the challenges doctors face when providing health care in detention settings. It argues that the detention of people who have not been convicted of a crime should be a measure of last resort and should be phased out.

Keeping Europe healthy. These presentation slides highlight the BMA's concerns about how Brexit may affect health care in the UK and the consequences for the NHS. 

Brexit: the implications for health and social care. Although the EU has limited legal jurisdiction over how health and care services are organised and provided in member states (European Union undated), the UK’s vote to leave the EU will have major implications for health and social care in England. 

Consultations  

Facing the facts, shaping the future: A draft health and care workforce strategy for England to 2027. HEE is seeking views on a draft strategy that sets out the current workforce landscape, what has been achieved since 2012, the work underway and describe an approach to shaping the face of the NHS and social care workforce for the next two decades. It proposes a range of measures to improve productivity, boost training and retention, open up new routes into nursing and prepare the future workforce for technological advances such as genomics, artificial intelligence and digital robotics, which are poised to transform modern medicine. The closing date for comments is 23 March 2018.

Consultation on introducing 'opt-out' consent for organ and tissue donation in England. The DH is seeking views on plans to make it easier for people to give consent to be an organ donor. The changes include moving to an 'opt-out' system, that would shift the balance of presumption in favour of organ donation. The consultation closes on 6 March 2018.  

News 

NHS cancels surgery for tens of thousands to avoid winter crisis. Hospital chiefs are told by NHS England to take drastic action, including setting up makeshift wards.

NHS to join forces with major developers to build a healthy national future. NHS England is calling on the country’s top housing developers to apply the lessons from the first healthy new towns schemes by creating a national network that will put healthy living at the heart of future home building. In January 2018, NHS England will be inviting applications for housing developers and associations to join a national network that will help improve the health of the nation. 

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

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