Health and Social Care Update - July 2017

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

03/07/2017

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

Mental Health

Acute and emergency care

Primary Care

Children

Providers

Clinical Risk/Patient Safety

Public Health

Commissioning

Regulation

Employment/HR

Social care

Finance

General 

Information sharing/data

 

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Bevan Brittan Free Training Events

Court of Protection Seminars -  SAVE THE DATE

In October and November, Bevan Brittan's specialist Court of Protection team is hosting practical update sessions in Bristol, Birmingham, London and Leeds. These sessions will focus on practical issues that practitioners, commissioners and providers encounter in matters engaging the Court of Protection; covering relevant legislation, guidance and case law and their impact on managing incapable patients. They will offer guidance on the sort of problems that are faced by front-line practitioners and service planners. The sessions are aimed at all those working in organisations responsible for the care of vulnerable or incapable people both as care providers or commissioners. The sessions will run from 10:00 – 15.30. Registration for all sessions will open at 09:30 and lunch will be available.

  • 31 October – Bristol
  • 7 November – London
  • 8 November – Birmingham
  • 9 November – Leeds

If you would like to register your interest in one of the above seminars click on this link.

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 session coming up this month is:-

  • A guide to the brain, injuries and consequences. 4 July 12:30 - 2:00pm. A common subject of claims and often very high value. If you would like to attend this free lunchtime webinar just ask Claire Bentley.

  • A look at the importance of notes & managing expert witnesses. 18 July  12:30 - 2:00pm. Two issues that can win or lose cases. If you would like to attend this free lunchtime webinar just ask Claire Bentley.

Bevan Brittan training packages

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

What is happening to waiting times in the NHS? This briefing finds that key performance measures for hospital services are being missed on a regular basis. The NHS is treating more patients than ever before, with activity increasing across the board. Waiting lists for elective care, and the number of patients who have not been treated in A&E within four hours or received cancer treatment within 62 days from GP referral, have increased. But the volume of elective care and the number of patients who have been treated within the cancer treatment standard has also increased, reflecting the overall increase in demand for NHS care.

News

More A&E funding to help hospitals prepare for winter. The Health Secretary has announced that £20.74m has been awarded to 27 hospitals in England, as part of the dedicated funding announced in the Spring Budget to ensure local A&Es are prepared for the additional demands that winter brings.. This follows an initial £55.98m given to 70 hospitals in April. 
 

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

What policies are needed to improve children’s health? A key test of public policy is how well it addresses the needs of future generations as well as those of the current one. This requires explicit consideration of the needs of infants, children and young people, without assuming that these will be the same as adults’. The UK has slipped down international league tables health indicators for infants, children and young people, especially for infant mortality This King's Fund briefing finds that progress is currently slipping in some areas and there is a need to reinvigorate policy to protect and improve children’s health.

Health matters: child dental health This guidance outlines how health professionals can help prevent tooth decay in children under five.

Report on transition of care between childhood and adulthood for people with diabetes A new report that charts the care of young people with Type-1 diabetes as they move from paediatric to adult services has been published for the first time by NHS Digital1.

Consultation

Child Cruelty Consultation A Sentencing Council consultation seeks comments on guidelines for sentencing offenders guilty of child cruelty. The draft guidelines cover three offences: cruelty to a child; causing or allowing a child to die or suffer serious physical harm; and failing to protect a girl from the risk of female genital mutilation (FGM). Comments by 13 September 2017. 

News

Public inquiry into child abuse has cost £35m in two years but has yet to publish a report. Figures published on 27 June 2017 by the Independent Inquiry into Child Sexual Abuse show expenditure of £20.8 million in 2016-17 including more than £9 million on staff and £5.1 million on lawyers, where only one set of substantive hearings has taken place, into the suffering of children sent to schools in Australia under state-approved migration programmes.

Bevan Brittan Updates

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

Tackling variations in clinical care: assessing the Getting It Right First Time (GIRFT) programme. The GIRFT programme aims to bring about higher-quality care in hospitals, at lower cost, by reducing unwanted variations in services and practices. Through an informal assessment of the programme, this paper sets out what the programme is, why it is needed, what is different about it, what it has achieved, what challenges it faces and what potential it has. The evidence to date suggests that the GIRFT programme is achieving what it has set out to achieve – higher-quality care in hospitals at lower cost – with the engagement of both clinicians and managers. However, engagement varied, and sustained success will depend on engagement of both clinicians and managers and a commitment to taking action.

Investigation: clinical correspondence handling at NHS Shared Business Services. In March 2016, NHS Shared Business Service (NHS SBS) informed NHS England and the Department of Health that it had discovered a backlog of approximately 435,000 items of unprocessed clinical and other correspondence. This report outlines the findings of an investigation into how NHS SBS handled unprocessed clinical correspondence. As at 31 May 2017, the review of the backlog of correspondence has found 1,788 cases of potential harm to patients and NHS England have estimated that the cost of the incident will be at least £6.6 million.

Action needed to prevent confusion over medicines. This report highlights the significant difficulties patients and some healthcare professionals face in using evidence from research to judge the benefits and harms of medicines, and calls for concerted action to improve the information patients receive

Report urges reform to curb rising costs of NHS clinical negligence. A report by the Medical Protection Society urges reforms to curb the costs of clinical negligence, which it says have risen by 72% over the five years to 2015/16. It suggests taxpayers could be paying £2.6 billion a year by 2022, with the NHS having spent £1.5 billion on clinical negligence in 2016. The report "The rising costs of clinical negligence: who pays the price?" argues that the rising costs are unsustainable without reform and that there must be "reasonable compensation" balanced by society's ability to pay.

Medical defenders: We need to talk about compensation costs

Each baby counts. The Royal College of Obstetricians and Gynaecologists’ Each Baby Counts initiative is a national quality improvement programme that aims to halve the number of babies who die or are left severely disabled as a result of preventable incidents occurring during term labour (after 37 weeks) by 2020. This detailed analysis of all stillbirths, neonatal deaths and brain injuries that occurred during childbirth in 2015 has identified key clinical actions needed to improve the quality of care and prevent future cases.

How can we assess how well providers review, investigate and learn from deaths? The CQC would like views on how they can strengthen the way they look at whether NHS trusts learn from deaths to improve the care they provide.

Cases

Megan Tanner (a child by her father and litigation friend) v Sarkar (2017) LTL 4 April (HHJ Buckingham, Hull CC). The claimant had not made out her claim against the defendant GP for damages for psychiatric injuries which she claimed to have sustained as a secondary victim as a result of witnessing events surrounding the death of her younger brother. Although the defendant's negligence had led to her brother's death, she had failed to show that she had developed a recognised psychiatric disorder or suffered a recognised psychiatric injury as a result of witnessing the relevant events.

Director of the Serious Fraud Office v Eurasian Natural Resources [2017] EWHC 1017 (QB). The court considered, for the first time, the circumstances in which litigation privilege and legal advice privilege could arise against a background of potential criminal litigation rather than civil litigation.

Neilson v Argos Distribution Ltd (2017). The claimant, a 43-year-old woman, received £567,829 on a 100% liability basis for the fibromyalgia suffered following a workplace accident in September 2012. She experienced depression, chronic fatigue, neurological pain, cognitive impairment, her mobility and independence were reduced and she could no longer work after struggling for two-and-a-half years.

Hegarty v University Hospitals Birmingham NHS Foundation Trust. A patient's claim that a hospital had been negligent in obtaining her consent to a second operation and that she should have been offered the option of alternative treatment failed as on the balance of probabilities she would have consented to the operation, albeit reluctantly, even if all the alternatives had been explained to her. However, she was entitled to damages for her negligent treatment by the nursing staff during her admission.

Diamond v Royal Devon & Exeter NHS Foundation Trust [2017] EWHC 1495 (QB) The Court found that a totally honest witness was not correct in her assessment of what she would have done if she had been given the correct information.

Dodd v Raeburn [2017] EWCA Civ 439. All parties can apply for summary judgment in cases involving personal injury and death. “The hope that something may turn up in cross-examination of a witness at the trial does not suffice.”

Peter Stanton v Henry Hunter (2017) A finding of fundamental dishonesty under the Criminal Justice and Courts Act 2015 s.57 was made against a claimant in his claim for damages for personal injuries and other losses sustained as a result of an accident which occurred while he was working on a property owned by the defendant, and accordingly his claim was dismissed. Pursuant to s.57(4), the court assessed the damages it would have awarded but for the dismissal.  

Bevan Brittan Training

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 session coming up this month is:-

  • A guide to the brain, injuries and consequences. 4 July 12:30 - 2:00pm. A common subject of claims and often very high value. If you would like to attend this free lunchtime webinar just ask Claire Bentley.
  • A look at the importance of notes & managing expert witnesses. 18 July  12:30 - 2:00pm. Two issues that can win or lose cases. If you would like to attend this free lunchtime webinar just ask Claire Bentley.

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 

Checklist for recruiting CCG lay members This checklist aims to support CCGs with recruiting lay members and provides a series of questions that can be asked to start conversations about both recruitment and succession planning.

Patient and public participation in commissioning health and care: statutory guidance for CCGs and NHS England. Guidance for CCG and NHS England staff on how to involve patients and the public in their work in a meaningful way to improve services, including giving clear advice on the legal duty to involve.

Managing conflicts of interest in the NHS. NHS England has published updated guidance for CCGs on managing conflicts of interest.

Sustainability and Transformation Plans: How serious are the proposals? A critical review. This report from London South Bank University argues that, to deliver a better future for the NHS, the 44 existing Sustainability and Transformation Plans (STPs) for the NHS in England, initiated by NHS England in December 2015, would need to be given the legislative powers and support necessary to achieve effective collaboration, plus some much-needed clarification on their role. The report also recommends that STP leaders need to plan ahead based on the reality of their current situation, identify changes that are evidence-based, develop workforce plans that match their ambitions, and focus on reducing demand before removing resources from the acute sector. At present some elements of these recommendations are missing in all of the 44 published STPs. Overall, this critical review reveals a distinct lack of comprehensive planning and evidence-based policy making, in all 44 STPs, of sufficient quality needed to deliver the level, pace and scale of change required for the future transformation of the NHS.

NHS England bite-size guides to patient insight. NHSE has published two further short guides to help providers and commissioners understand the use of patient insight better and to use it effectively in delivering local services. The latest look at: Building greater insight through qualitative research and Helping people with a learning disability to give feedback.

NHS commissioning of specialised services. This Commons Library briefing paper looks at the commissioning of specialised services by the NHS in England, for patients with rare or complex conditions. It sets out how the commissioning process works, as well as analysis of the financial management and transparency of specialised commissioning, and recent reforms introduced by NICE and NHS England, including reforms to the Cancer Drugs Fund.

CCG Lay Members, Non-Executive Directors and STP Governance and Engagement: Report from network events organised by NHS England and NHS Clinical Commissioners in February 2017. This briefing brings together ideas from four workshops organised in February 2017 for lay members on CCG governing bodies and NEDs from NHS Trusts. The events focused on governance and engagement in the Sustainability and Transformation Plans (STPs) process.

Where next for commissioning? This report is the first in a series which promotes the views of leaders from a range of trusts and other parts of the service on some of the key issues facing the NHS today. The report includes eight interviews that address concerns including the role of STPs and accountable care systems, the challenge of integrating health and care commissioning, and the future of the purchaser-provider split. Contributors include leaders of hospital, mental health and community trusts and ambulance services, with additional perspectives from a CCG and local government.  

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

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Employment/HR

Publications/guidance

BMA quarterly survey. This report outlines the findings of the most recent BMA quarterly survey of doctors which explores their working conditions, levels of stress and morale. This quarter's survey also focuses doctors' views and perceptions of the impact of Brexit on the profession and health services. The survey finds that two-thirds of hospital doctors have experienced rota gaps in the last twelve months and that since the last survey, the amount of doctors reporting low moral has risen from 36 per cent to 44 per cent.

Consultations

Education consultation. The Nursing and Midwifery Council has launched a consultation seeking views on a wholesale review of the standards that UK trained nurses will need to meet before they can work as a registered nurse. sets out proposals for a new education framework for nursing and midwifery education. The proposed framework details a range of new outcome focused standards for education institutions and practice placement partners. The closing date for comments is 12 September 2017. 

Phase 2 implementation of the Regulation and Inspection of Social Care (Wales) Act 2016 – Workforce aspects. The 2016 Act establishes a new system of regulation and inspection which upholds the rights of Welsh citizens to dignified, safe and appropriate care and support. This paper seeks views on draft regulations that require providers of domiciliary support services to distinguish between travel time and care time, and provide domiciliary care staff with an alternative to zero-hours contracts. The consultation closes on 7 August 2017. 

Returning to practice. This guidance aims to help people who have taken a break from practice, or are considering doing so, to understand the requirements for coming back on to the HCPC register. It helps to ensure that registrants who have been out of practice for more than two years, and wish to return, update their knowledge and skills in order to resume safe and effective practice.  

Bevan Brittan Updates

  • Brexit - EU Nationals and their Immigration Status. Many EU nationals working and residing in the UK are uncertain as to what Brexit will mean for them. What is the current legal position and what should employers be doing now in order to address employee concerns?

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

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Finance 

Publications and Guidance

NHS expenditure This briefing documents NHS expenditure since 1948. It also contains a summary of the structure of the NHS and how it is financed.

Department of Health guidance for laying annual report and accounts before Parliament. Guidance for NHS foundation trusts, DH agencies, special health authorities, DH non-departmental public bodies (NDPBs), including NHS England, and the core department on how they should lay their annual report and accounts before Parliament. This detailed guidance supports the more general guidance included as part of the DH group accounting manual (GAM). It does not apply to NHS trusts, CCGs, consolidated limited companies or NHS charities.

The structure of the NHS in England. This Commons Library briefing provides an overview of the funding and accountability relationships within this NHS in England, and an introduction to the roles of key organisations including NHS England, NHS Improvement and the Care Quality Commission. It also highlights some key health policy issues, including patient safety, funding, and the integration of health and social care. 

How is the NHS performing? June 2017. The latest King's Fund quarterly monitoring report finds that the NHS is now planning to delay or cancel spending in half of local areas this year to meet financial targets. The survey of NHS trust finance directors suggests that NHS finances have improved over the last quarter of 2016/17. But whilst progress has been made in reducing agency spending, the underlying financial position remains a source of concern with many trusts having relied on one-off actions to improve their financial position.  

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

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Information sharing/data

Publications and Guidance

Linking and sharing routine health data for research in England This briefing discusses how the use of research using de-identified routine health data can provide unique insights to improve population health. It identifies the barriers and challenges to the wider use of routine health data.  

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

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Mental Health

Publications/Guidance

A Mental Health Act fit for tomorrow: an agenda for reform. This report urges the government to act on its promise to reform the Mental Health Act and take into account the views of those affected by mental illness. It includes the views of over 8000 people who use mental health services, carers, and professionals working in the field. Half of those who responded did not think that people are treated with dignity and respect under the Mental Health Act.

Mental health in prisons. Report by National Audit Office says that the government does not know how many people in prison have a mental illness, how much it is spending on mental health in prisons or whether it is achieving its objectives. It is therefore hard to see how Government can be achieving value for money in its efforts to improve the mental health and well being of prisoners. In 2016 there were 40,161 incidents of self-harm in prisons and 120 self-inflicted deaths.

People with learning disabilities: making reasonable adjustments. These guides explain why reasonable adjustments must be made to services and what adjustments help people with learning disabilities access services.

The Transparency pilot: A note from the Vice President of the Court of Protection.

Mental health policy in England. This Commons Library briefing covers measures taken to achieve "parity of esteem" between mental and physical health, in terms of access to services, quality of care and allocation of resources. It covers policies introduced under the 2010-2015 Coalition Government, and those introduced under the 2015-2017 Conservative Government, such as the Five Year Forward View for Mental Health (published February 2016).
Further information on policy on child and adolescent mental health services (CAMHS), including work to improve the provision of mental health services in schools, is available in the briefing on Children and young people’s mental health – policy, CAMHS services, funding and education.

Claiming travel costs as a public authority or professional deputy. An Office of the Public Guardian (OPG) practice note for solicitor and public authority deputies explains the OPG's interpretation of the Court of Protection's practice direction on fixed costs, including what travel costs cover and how to calculate travel costs.

Getting the dementia pathway right. NHS RightCare has published a scenario featuring fictional patient Tom and his wife and carer Barbara, to compare a sub-optimal dementia care pathway with an ideal pathway.  

Cases

Jasmin Djaba v (1) West London  Mental Health Trust (2) Secretary of State for Justice [2017] EWCA Civ 436. The Court of Appeal considered whether the statutory tests within the Mental Health Act 1983 s.72 and s.73 required a "proportionality assessment" to be conducted, pursuant to ECHR art.5, taking into account the conditions of a restricted patient's detention.

Re IH (Observance of Muslim Practice) [2017] EWCOP 9 (CoP). The court gave guidance on the application of the "best interests" test when considering fasting and hair removal in accordance with Muslim practice in the case of a person with a profound learning difficulty. 

News

NHS England to invest in building the right support for people with a learning disability. NHS England has announced >£10m investment to help patients with a learning disability, autism or both, to lead more independent lives, closer to their friends and family. The funding will support 14 local Transforming Care Partnerships, made up of NHS organisations, local authorities and NHS England commissioners, to develop new, high-quality, community services for people in their area.

NHS England announces new sites to redesign mental health services and cut out of area placements. Announces a new tranche of sites to test new approaches to delivering mental health services – cutting the number of people travelling long distances for care. Eleven new sites will be tasked with bringing down the number of people who receive in-patient hospital treatment and for those who do need more intensive care, that this is available closer to home. The pilot sites, made up of NHS mental health trusts, independent sector and charitable organisations will work together, sharing a local budget, to effectively reorganise services in their area to provide the best care for patients.  

Bevan Brittan Events

Court of Protection Seminars -  SAVE THE DATE

In October and November, Bevan Brittan's specialist Court of Protection team is hosting practical update sessions in Bristol, Birmingham, London and Leeds. These sessions will focus on practical issues that practitioners, commissioners and providers encounter in matters engaging the Court of Protection; covering relevant legislation, guidance and case law and their impact on managing incapable patients. They will offer guidance on the sort of problems that are faced by front-line practitioners and service planners. The sessions are aimed at all those working in organisations responsible for the care of vulnerable or incapable people both as care providers or commissioners. The sessions will run from 10:00 – 15.30. Registration for all sessions will open at 09:30 and lunch will be available.

  • 31 October – Bristol
  • 7 November – London
  • 8 November – Birmingham
  • 9 November – Leeds

If you would like to register your interest in one of the above seminars click on this link.

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.

Issues that are currently being discussed on our forum are:-

Bevan Brittan Updates

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

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Primary Care

Publications/Guidance

Is general practice in crisis? This King's Fund briefing examines the pressures on GPs and the profession's recruitment and retention crisis, in light of reports that people are finding it more difficult to access their GP.  

Cardiovascular disease: primary care intelligence packs. This resource, originally developed for Norwich CCG, aims to support the monitoring of prevalence, variation and treatment of cardiovascular conditions in the local area. This can help with planning, commissioning and improving local services. The pack uses GP practice data on prevention, detection and management across a range of cardiovascular conditions including high cardiovascular risk and hypertension, stroke and atrial fibrillation and diabetes. 

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

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Providers

Publications/Guidance

NHS England bite-size guides to patient insight. NHSE has published two further short guides to help providers and commissioners understand the use of patient insight better and to use it effectively in delivering local services. The latest look at: Building greater insight through qualitative research and Helping people with a learning disability to give feedback.

Accountable care organisations (ACOs) explained. King's Fund guide to ACOs, which build on previous efforts to integrate services in the NHS and their development draws on experience from health systems in the United States and other countries. They come in a variety of forms ranging from closely integrated systems to looser alliances and networks.

The hospital as a multi-product firm: The effect of hospital competition on value-added indicators of clinical quality. This paper from the LSE Centre for Economic Performance examines the impact of the introduction of patient choice in elective surgical procedures on Patient Reported Outcome Measures (PROMs). It studies the impact of a major competition-promoting reform to the English NHS in 2006, in which patients were allowed to choose which hospital they attended for elective surgery, on PROMs of health gain from hip and knee replacement, groin hernia repair, and varicose vein surgery. In contrast to the existing literature, it finds that the competition brought about by the introduction of patient choice of hospital may have had a negative effect on clinical quality.

News

NHS moves to end “fractured” care system. Simon Stevens, the head of NHS England, has announced eight 'accountable care systems' that will bring together local NHS organisations, often in partnership with social care services and the voluntary sector. They build on the learning from and early results of NHS England’s new care model vanguards. He also announced a new devolution agreement in Surrey Heartlands, similar to the existing one in Greater Manchester, that will bring together the NHS locally with Surrey County Council to integrate health and social care services and give local leaders and clinicians more control over services and funding.

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

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Public Health

Publications/Guidance

What policies are needed to improve children’s health? A key test of public policy is how well it addresses the needs of future generations as well as those of the current one. This requires explicit consideration of the needs of infants, children and young people, without assuming that these will be the same as adults’. The UK has slipped down international league tables health indicators for infants, children and young people, especially for infant mortality This King's Fund briefing finds that progress is currently slipping in some areas and there is a need to reinvigorate policy to protect and improve children’s health.  

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

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Regulation

Publications/Guidance

How can we assess how well providers review, investigate and learn from deaths? The CQC would like views on how they can strengthen the way they look at whether NHS trusts learn from deaths to improve the care they provide.

Driving improvement: case studies from eight NHS trusts This report contains case studies of eight trusts that have shown significant improvement since a previous inspection. It explores what these trusts have done to become 'well-led'. The CQC asked people in those trusts how they had achieved improvements, looked at the steps their leaders had taken and the effect of those actions on staff and patients.

Consultations

Our next phase of regulation: consultation 2. CQC is seeking views on a further set of proposals which will help shape its next phase of regulation of health and social care in England. The proposals include: Changes to the regulation of primary medical services and adult social care services, including the frequency and intensity of inspections and how it monitors, provides and gathers intelligence; improvements to the structure of registration and the definition of 'registered providers'; and further information on how it will monitor, inspect and rate new models of care and large or complex providers. The closing date for comments is 8 August 2017.
CQC has also published its Response to the first consultation on CQC’s next phase of regulation, which closed in February. It includes more information about key changes to the assessment frameworks, registration guidance for learning disability services and how it will regulate NHS trusts.

Education consultation. The Nursing and Midwifery Council has launched a consultation seeking views on a wholesale review of the standards that UK trained nurses will need to meet before they can work as a registered nurse. sets out proposals for a new education framework for nursing and midwifery education. The proposed framework details a range of new outcome focused standards for education institutions and practice placement partners. The closing date for comments is 12 September 2017.  

Bevan Brittan Events

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

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Social Care

Publications/Guidance

Care homes market study: update paper The care homes market study was launched in December 2016 to examine whether the residential care homes sector is working well for elderly people and their families. This report outlines the emerging findings and it focuses on concerns about certain care homes charging families for extended periods after a resident has died, and homes charging large upfront fees.

Adult social care funding (England). This Commons Library briefing paper examines the key funding pressures facing adult social care services in England and evidence of the impacts of these pressures on social care and health services. The paper explains the additional funding for adult social care that the 2015 Conservative Government announced in the last Parliament, and discusses wide-spread concerns about a growing social care ‘funding gap’ and the need for a long-term sustainable funding solution.

Health and social care integration. Updated Commons Library briefing paper analyses recent policy and debate on the integration of NHS-provided healthcare and local authority-provided social care in the UK. This has been a key policy priority for successive Governments, with the aim of improving patient care and saving money for the NHS and local authorities.

Health and social care integration: Round table write-up. Health and social care integration is something of a hot-button issue recently, as the development of Sustainability and Transformation Plans has reflected the lack of progress in some areas. Reflecting its increasing prominence, NLGN convened two roundtables in London and Manchester with a range of officers, practitioners, elected members and thought leaders from the local government and health fields. These roundtables were held in January and March 2017 and this write-up is based on those discussions.

Improving social wellbeing in the City of London. Sets out the City of London Corporation's plans to tackle social isolation in the City of London. It summarises the first lot of findings from the Social Wellbeing Panel that was established in 2016 to learn more about how to reduce loneliness and to hear about activity that has been successful elsewhere.

Beat the heat: keep care home residents safe and well. Guide for care home staff on how to prepare for hot weather. It should be read alongside the Heatwave Plan for England. 

Consultations

Phase 2 implementation of the Regulation and Inspection of Social Care (Wales) Act 2016 – Workforce aspects. The 2016 Act establishes a new system of regulation and inspection which upholds the rights of Welsh citizens to dignified, safe and appropriate care and support. This paper seeks views on draft regulations that require providers of domiciliary support services to distinguish between travel time and care time, and provide domiciliary care staff with an alternative to zero-hours contracts. The consultation closes on 7 August 2017. 

News

Thousands of private hospitals and care homes ordered to check fire safety

Family charged thousands of pounds for care a nursing home could not prove it had provided. The LGO has criticised Worcestershire CC after a care home provider charged a vulnerable dementia patient for care which it could not prove it had provided. The LGO found that the Council had failed to assess the woman’s needs properly, including her mental capacity, following her move. Because of this flawed assessment, the Council wrongly regarded the woman as capable of self-funding her own care. Although the woman had the savings to fund her own care, she had no capacity to do so and no-one to manage her finances. Despite this, and contrary to the law, the Council stopped paying for the woman’s care. As well as requiring new invoices to be issued and the patient's estate to be refunded, the LGO also made a number of recommendations for the Council to improve working with the hospital and social workers and to review whether it works with the care provider in future.

Ombudsman finds systemic fault in council’s charging policy for Dudley care homes. The LGO has reminded local authorities of the need to offer affordable care home placements to families when arranging relatives’ care. This follows an investigation into Dudley MBC where the LGO upheld a complaint from a family who were given no alternative but to pay a ‘third party top-up fee’ to help pay for their mother’s care. 

Bevan Brittan Updates 

Bevan Brittan Events

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

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General

Publications/Guidance

Acting without delay: How the independent sector is helping the NHS reduce delayed discharges. This report is the first in a series that looks at a range of innovative partnerships between the independent sector and the NHS which are helping some of the most vulnerable NHS patients to get the right care in the right place at the right time.

Abortion Statistics, England and Wales: 2016 Summary information from the abortion notification forms returned to the Chief Medical Officers of England and Wales.

NHS pressures. Analysis of NHS performance published by the BMA shows that last winter was one the worst winters on record, with all key performance markers showing a health system that is struggling to cope with demand. Bed occupancy, delayed transfers of care and waits at A&E are all increasing, with patients waiting longer for ambulances, treatment and admission. Targets are consistently not being met across the health system. Today doctors’ leaders are warning that these trends are only going to worsen. 

Winter warning: managing risk in health and care this winter. This report highlights concerns from NHS leaders around the ability of the health system to respond to mounting pressures next winter. It argues that the extra £1bn social care funding committed to easing delayed transfers of care will not be sufficient with 91 per cent of trusts reporting a lack of capacity in social care. The report calls for a funding injection of £350m to ensure that there is enough capacity across the system and to ensure adequate resourcing.

2016 adult inpatient survey: statistical release. This CQC report outlines the findings of the 2016 adult inpatient survey which illustrates the experiences of over 77,000 patients who received care in an NHS hospital during July 2016. It provides a snapshot of the quality of care in NHS hospitals and finds that patient experience has remained relatively stable since 2006. The report identifies significant improvements in the quality of communication and confidence in medical staff. However it warns that there are a substantial amount of areas that have shown decline, such as patient involvement, waiting times and post-discharge care.

The hospital as a multi-product firm: the effect of hospital competition on value-added indicators of clinical quality. This paper examines the impact of the introduction of patient choice in elective surgical procedures on patient reported outcome measures (PROMs). It finds that by introducing competition via the mechanism of patient choice, there may have been a negative effect of clinical quality.

International profiles of health care systems. This report from the Commonwealth Fund presents an overview and comparison of the health care systems of 19 countries around the world. Each overview covers health insurance, public and private financing, health system organisation and governance, health care quality and coordination, disparities, efficiency and integration, use of information technology and evidence-based practice, cost containment, and recent reforms and innovations. In addition, summary tables provide data on a number of key health system characteristics and performance indicators, including overall health care spending, hospital spending and utilisation, health care access, patient safety, care coordination, chronic care management, disease prevention, capacity for quality improvement, and public views.

How does the NHS compare internationally? The King's Fund compares different countries’ health systems to provide an important perspective on what the NHS does well and where it should seek to improve.

Getting a Brexit deal that works for the NHS. The second of the Nuffield Trust's election briefings points out that ahead of the 2017 General Election, polls show that the public say that the two most serious issues facing Britain are leaving the European Union, and the NHS – and stresses that the two issues are closely connected. The briefing sets out what the next government needs to secure under the Brexit deal in order to protect the interests of the NHS, social care and the people who use them.

Cases

R (on the application of (1) A (A Child by her litigation friend B) (2) B) v Secretary of State for Health [2017] UKSC 41 The Secretary of State for Health in England had not acted irrationally or unlawfully in refusing to exercise his power to require the provision of free abortion services to women from Northern Ireland in the same way that they were provided to women from England. Although the decision fell within the scope of ECHR art.8 it was justified and the difference in treatment did not amount to discrimination under art.14 .

News

NHS England’s Chief Scientific Officer’s Knowledge Transfer Partnership winners announced. NHS England, in partnership with the National Measurement System (NMS) – the government funded body that maintains the UK measurement infrastructure – has announced the winners of its first Chief Scientific Officer’s (CSO) Knowledge Transfer Partnership Programme.

NHS England kicks off international search for ground-breaking patient-care innovations. NHS England Chief Executive Simon Stevens has confirmed a further round of the NHS Innovation Accelerator programme that will focus on the clinical priorities outlined in the Next Steps Five Year Forward View plan including mental health, primary care and urgent and emergency care. NHS England has also opened a new Innovation Technology Payment system (developed from the Innovation Technology Tariff) which will help NHS Trusts and Clinical Commissioning Groups to quickly spread new innovations in the medtech, diagnostic and digital sectors across primary, secondary and mental health care. It aims to cut the red tape and hassle for NHS organisations by overcoming financial and procurement barriers, for example by introducing a reimbursement for usage or centrally purchasing items.

GMC warns patients not to take risks for a 'beach body' The General Medical Council (GMC) has warned people considering cosmetic interventions in search of a ‘beach ready’ body to think twice before embarking on what could be risky procedures.

Doctors back decriminalisation of abortion. The British Medical Association (BMA) has called for the decriminalisation of abortion, to remove any threat of prosecution for patients and health workers. Abortion is illegal in the UK under the Offences Against the Person Act 1861, but the Abortion Act 1967 created exceptions if a woman could secure the agreement of two doctors that a termination was necessary.

Public inquiry into child abuse has cost £35m in two years but has yet to publish a report. Figures published on 27 June 2017 by the Independent Inquiry into Child Sexual Abuse show expenditure of £20.8 million in 2016-17 including more than £9 million on staff and £5.1 million on lawyers, where only one set of substantive hearings has taken place, into the suffering of children sent to schools in Australia under state-approved migration programmes.

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