Health and Social Care Update - April 2018

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

16/04/2018

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

Primary Care

Acute and emergency care

Procurement

Children

Providers

Clinical Risk/Patient Safety

Public Health

Commissioning

Regulation

Employment/HR

Social care 

Independent Healthcare

General 

Mental Health

 

If someone forwarded you this email you can sign up for your own free copy here delivered directly to your inbox.  

Bevan Brittan Free Training Events

South West Medico-Legal Seminar. This half day seminar, aimed at legal, claims, and risk personnel working in health bodies, will provide you with all the information you need to widen your knowledge and get up to update on current hot legal topics in healthcare. We have chosen topics with practical applications in order to provide you with useful advice that can then be shared in your organisation. Thursday 03 May 2018, 08:30. Taunton and Somerset NHS Foundation Trust.

Employment tribunals: Limbering up for Increasing Claims. The practical impact of the Supreme Court's surprise decision to quash employment tribunal fees is now being felt: employment tribunal and Acas statistics are showing steep rises in claims, with the inevitable effect that 2018 is the year that employers must polish up their dispute resolution and employment tribunal management skills:-
London. Tuesday 22 May 2018, 09:30
Leeds. Tuesday 05 June 2018, 09:30
Bristol. Wednesday 06 June 2018, 09:30
Birmingham. Wednesday 13 June 2018, 09:30 

Key Topics for Social Care Providers. Bevan Brittan is a leading law firm advising providers across the whole social care spectrum. We have specialist insight into the challenges and opportunities for the sector arising from political policy, funding and financing, innovation, new models of care, workforce issues and regulation. We have invited industry experts to join us in reviewing and debating the current hot topics for social care providers:-
Bristol Wednesday 02 May 2018, 16:00
Birmingham Wednesday 09 May 2018, 09:30
London Wednesday 16 May 2018, 09:30

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. You can sign up to watch the training sessions remotely via our webinar facility.  Just ask Claire Bentley. 

The  lunchtime training sessions coming up are:-  

  • Mental Health Update - Tuesday 8 May 12.30pm - 2pm. Paul Barber continues his overview of the MHA 1983 and overlap with the MCA. This session focuses on managing the patient when detained.
  • Chronic pain syndromes and clinical negligence. - Tuesday 15 May 12:30pm - 2pm. This session will consider the following issues:-
    To understand if the alleged failings in care caused the pain condition
    What can be done to ameliorate the condition, enable recovery and control the value of the claim.

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 

Integrated Urgent Care / NHS 111 Workforce Blueprint. This document has been developed to ensure that there is a sustainable and optimal Integrated Urgent Care call centre workforce with the right skills, behaviours and competencies. It supports the vision for a multi-disciplinary, highly professional clinical and non-clinical workforce and has been designed to support commissioners and providers deliver the Integrated Urgent Care Service Specification to the right standards and quality levels.

Emergency admissions data briefing. The charity Marie Curie, which provides care and support to people living with any terminal illness and their families, has collected new data that for the first time shows the true impact of a failure to significantly improve community care services over the next few years. It finds that in 2016, there were over 1.6m emergency admissions for people in the last year of their life, amounting to around 11m days in hospital and costing the NHS £2.5bn.

News

Paramedics given the power to prescribe drugs and undertake home visits. From 31 March 2018, paramedics are to be given the power to prescribe medicines and undertake home visits to reduce the number of patients that need to be transported to hospital, after NHS England raised concerns that GPs are struggling to deal with increasing demand for appointments from an ageing population with complex health problems.

Hunt orders new ambulance handover plan following 'unacceptable' delays. Jeremy Hunt has told system leaders to draw up new plans to tackle handover delays this month after efforts to curtail ambulance queues outside hospitals failed this winter

Care home pharmacists to help cut overmedication and unnecessary hospital stays for frail older patients. NHS England has announced plans to recruit and deploy hundreds of pharmacists into care homes to help reduce overmedication and cut unnecessary hospital stays. NHS trials show pharmacists reviewing medicines improved patients’ quality of life by reducing unnecessary use and bringing down emergency admissions, with less time spent in hospitals. This approach also led to meaningful savings in unnecessary prescribing costs of £249 per patient in one pilot over a year.

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 

Are we listening? Describes the findings of the CQC independent review of the system of services that support children and young people’s mental health. The report finds that too many children and young people reach ‘crisis point’ before accessing mental health services

Learning disabilities and behaviour that challenges: service design and delivery. This guideline suggests that children, young people and adults with a learning disability and behaviour that challenges should have the right support to live their lives in the community. It aims to promote a lifelong approach to supporting people and their families and carers, focusing on prevention and early intervention and minimising inpatient 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  

Tough task: the NHS delivering for patients and staff in 2018/19 Based on a survey of NHS trust leaders, this report reveals widespread scepticism about the ability of the service to meet performance and financial targets in 2018/19. It argues that patients' experience of care will continue to fall below the standards that trusts consider to be acceptable and that risk to quality and safety will grow, alongside the pressures on the workforce.

Introduction of combined trust-level quality and use of resources ratings. The guidance confirms the process that CQC will use to turn the findings and rating proposed by NHS Improvement following their assessment of the trust’s use of resources, into a final rating and outlines how the findings and ratings from use of resources assessments will be finalised through the quality assurance, factual accuracy and approval process used by CQC following its scheduled inspections of non-specialist acute trust services.

GMC announces terms of reference for gross negligence manslaughter review.  The GMC has announced the terms of reference for a cross-UK, independent review, to be led by Dame Clare Marx, into how gross negligence manslaughter is applied to medical practice. The work, which will be informed by the outcome of the Williams Review into the issues pertaining to gross negligence manslaughter in healthcare, announced by the Secretary of State for Health and Social Care in February 2018, will examine what needs to be done to improve how existing law, procedures and processes are applied. The working group undertaking the review will aim to report its findings to the GMC by the start of 2019.

Pre-legislative scrutiny draft personal injury discount rate clause. The Government proposes to maintain the principle that claimants should receive 100% compensation for losses they incur. It proposes that the discount rate applicable to lump sum damages invested by claimants should no longer be set with reference to returns from Index Linked Government Securities. Instead the draft legislation provides that the discount rate should be set on the assumption that claimants will invest lump sums in "low risk" investments, and having regard to actual investments made by claimants.

Personal injury discount rate: how it should be set in future: Consultation outcome. The Ministry of Justice has published documents that comprise the Government response to the March 2017 consultation on how the personal injury discount rate should be set in future. They include a Command Paper entitled "Personal Injury Discount Rate: Government response to the report of the Justice Select Committee" which seeks views on draft legislation which embodies those conclusions; an impact assessment; reports by the Government Actuary's Department and the British Institute of International and Comparative Law; and correspondence relating to the setting of the discount rate in February 2017.

Personal Injury Discount Rate: Response to the Report of the Justice Select Committee Draft Clause. A Ministry of Justice Command Paper responding to the report of the Justice Select Committee on the Personal Injury Discount Rate includes: responses to recommendations; and sections on how the rate should be set, who should set the rate and when the rate should be set.

Consultations

Accountable care models contract: proposed changes to regulations. The Government has issued its response to the September 2017 consultation on changes to the regulations on the running of an NHS standard contract (accountable care models) together with revised draft Amendments Relating to the Provision of Integrated Services Regulations 2018, revised draft Primary Medical Services (Prohibition on the Sale of Goodwill) Regulations 2018 and a brief guide explaining what ACOs are and how they could benefit patients and the NHS. The response states that the finalised regulations no longer mandate what form an ACO should take or what an ACO's responsibilities will be. Instead there is a new standard definition of an integrated service provider (ISP) and an integrated service provider contract (ISPC) that sets out who may be the commissioners of such a contract on the one part, and what services may be provided under or pursuant to that contract. The revised definitions clarify that the award of such a contract does not create a new legal entity.

Organisational Duty of Candour guidance. Scottish Government guidance focuses on the implementation of the legal duty of candour procedure for all organisations that provide health services, care services or social work services in Scotland. The organisational duty of candour underpins the Scottish Government's commitment to openness and learning which is vital to the provision of safe, effective and person-centred health and social care.

Rapid resolution and redress scheme for severe birth injury: consultation response. Over 200 unique responses were received, from stakeholders including:
• family members with personal experience of birth injury
• the organisations that support them
• frontline clinical and legal professionals

Cases  

Kai Surrey (A Child & Protected Party, By His Litigation Friend, Amy Surrey) v Barnet & Chase Farm Hospitals NHS Trust; AH (A Protected Party, By Her Litigation Friend, X) v Lewisham Healthcare NHS Trust; Mehmet Yesil (A Child & Protected Party, By His Litigation Friend, Alisan Yesil) v Doncaster & Bassetlaw Hospitals NHS Foundation Trust [2018] EWCA Civ 451.  Costs judges had been entitled to prevent the recovery of success fees and after-the-event insurance premiums incurred by patients who had successfully brought clinical negligence claims where the patients had switched, after liability was admitted, from legal aid funding to conditional fee agreements and ATE insurance, and the switch was based on unsound advice. The costs judges had rightly asked whether, had the advice been sound, that "could" have resulted in the patients deciding not to switch; the test was not whether sound advice "would" have resulted in a different decision.

News  

Clinical Negligence on Radio 4 - Are Lawyers Bankrupting the NHS? Clive Anderson and guests discuss the crisis hitting the NHS over negligence claims.

Women to have dedicated midwives throughout pregnancy and birth. Plans to train 3,000 more midwives over 4 years and further investment in maternity support staff.

Claimant lawyers will lose £81m a year as insurers pocket huge windfall - MoJ. An impact assessment (IA) for the Civil Liability Bill 2017, published by the Ministry of Justice (MoJ), forecasts that £32 million will be lost from claims that will no longer proceed. It also estimates that an additional £49 million is likely to be taken from firms' revenues where claims proceed but without the claimant having legal representation. The loss in revenue is expected, according to the IA, to be offset by a reduction in the work conducted.

Bevan Brittan Updates

NHS Resolution Court of Appeal success in ‘bulk conversion’ cases. NHS Resolution has saved the NHS £270,000 in legal costs claimed across three test cases heard in the Court of Appeal.

Bevan Brittan Events

South West Medico-Legal Seminar. This half day seminar, aimed at legal, claims, and risk personnel working in health bodies, will provide you with all the information you need to widen your knowledge and get up to update on current hot legal topics in healthcare. We have chosen topics with practical applications in order to provide you with useful advice that can then be shared in your organisation. Thursday 03 May 2018, 08:30. Taunton and Somerset NHS Foundation Trust. 

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. You can sign up to watch the training sessions remotely via our webinar facility.  Just ask Claire Bentley. 

The  lunchtime training sessions coming up are:-  

  • Mental Health Update - Tuesday 8 May 12.30pm - 2pm. Paul Barber continues his overview of the MHA 1983 and overlap with the MCA. This session focuses on managing the patient when detained.
  • Chronic pain syndromes and clinical negligence. - Tuesday 15 May 12:30pm - 2pm. This session will consider the following issues:-
    To understand if the alleged failings in care caused the pain condition
    What can be done to ameliorate the condition, enable recovery and control the value of the claim.

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

Conditions for which over the counter items should not routinely be prescribed in primary care: Guidance for CCGs. Guidance on how CCGs take the proposed conditions for which over the counter items should not routinely be prescribed into account in formulating local polices, and for prescribers to reflect local policies in their prescribing practice.

How commissioners use research evidence . This resource brings together research on the use of evidence by commissioners. It includes studies into the behaviour of individual managers and the way in which commissioning organisations make sense of and use research information when making decisions. The findings aim to provide practical pointers for researchers to make their work more accessible and relevant to commissioners and managers.

Planning, assuring and delivering service change for patients. This NHS England guidance is designed to be used by those considering, and involved in, substantial service change to navigate a clear path from inception to implementation. It will support commissioners and providers to consider how to take forward their proposals, including effective public involvement, enabling them to reach robust decisions on change in the best interests of their patients.

Responsibility for prescribing between primary and secondary/tertiary care. This guidance aims to provide clarity on the responsibilities of all professionals involved in commissioning and prescribing across primary, secondary and tertiary care, and to provide support in developing shared care agreements and in the transfer of care.

NHS Urgent Medicine Supply Advanced Service Pilot – Community Pharmacy service specification. The NUMSAS Pilot service manages a referral from NHS 111 to a community pharmacy where a patient has contacted NHS 111 because they need urgent access to a medicine or appliance that they have been previously prescribed on an NHS prescription. This updated document sets out the requirements for community pharmacy owners who wish to provide the NHS Urgent Medicines Supply Advanced Service Pilot. NHS England is commissioning this national pilot, via referral from NHS 111 or IUC CAS, in order to reduce the burden on urgent and emergency care services of handling urgent medication requests, whilst ensuring patients have access to the medicines or appliances they need. 

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

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Employment/HR 

News

Doctors subjected to "flawed" disciplinary procedures. A report published by the Medical Protection Society has accused hospital trusts of "stifling a learning culture" by rushing to discipline doctors in circumstances where the allegation does not warrant it. It highlights concerns that disciplinary procedures are "unnecessarily prolonged" and in some cases Trusts do not provide accused doctors with sufficient information about the allegation in advance a hearing. It calls for more transparency and fairness surrounding disciplinary procedures, with a clear method established to hold trusts to account where they are found to have behaved in a seriously wrong way during proceedings.

Doctor wins right to challenge dismissal decision. Hadiza Bawa-Garba, a junior doctor who was struck off the medical register in January 2018 by the General Medical Council after a 2015 conviction for gross negligence manslaughter, has won the right to challenge the decision at the Court of Appeal. It was argued that the ruling could harm patient safety by making staff reluctant to admit mistakes.

Bevan Brittan Events

Employment tribunals: Limbering up for Increasing Claims. The practical impact of the Supreme Court's surprise decision to quash employment tribunal fees is now being felt: employment tribunal and Acas statistics are showing steep rises in claims, with the inevitable effect that 2018 is the year that employers must polish up their dispute resolution and employment tribunal management skills:-
London. Tuesday 22 May 2018, 09:30
Leeds. Tuesday 05 June 2018, 09:30
Bristol. Wednesday 06 June 2018, 09:30
Birmingham. Wednesday 13 June 2018, 09:30 

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

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Independent Healthcare 

Publications/Guidance 

The state of care in independent online primary health services. This report finds that the quality of online primary care services, such as those that provide GP consultations and prescriptions through independent websites and apps, has improved over the past 12 months but further action from providers and the wider system is needed to ensure they are as safe as general practice in physical premises.  

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

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Mental Health

Publications/Guidance

Integrating mental health and social care: does it work in practice? This briefing looks at the integration of mental health services and social care, the benefits behind this and the challenges faced on the ground. It argues that the current pressures on both the health and care systems can conceal the day-to-day challenges of living with mental health problems, the distress of families and friends, and the struggle to stay well in their community. This briefing is free to download but requires free registration for full access.

Driving improvement: Case studies from seven mental health NHS trusts. What does it take to raise standards in a mental health trust? How can a trust that requires improvement become good or outstanding?

Mental Health Act – Approved Mental Health Professional services. This briefing paper gives our findings from a review of the way Approved Mental Health Professionals (AMHP) services are being delivered across the country.

Briefing – Mental health rehabilitation inpatient services. This briefing looks at mental health rehabilitation inpatient services, including ward types, bed numbers and use by clinical commissioning groups and NHS trusts.

Are we listening? Describes the findings of the CQC independent review of the system of services that support children and young people’s mental health. The report finds that too many children and young people reach ‘crisis point’ before accessing mental health services

Learning disabilities and behaviour that challenges: service design and delivery. This guideline suggests that children, young people and adults with a learning disability and behaviour that challenges should have the right support to live their lives in the community. It aims to promote a lifelong approach to supporting people and their families and carers, focusing on prevention and early intervention and minimising inpatient admissions.

Think Autism strategy: Governance refresh 2018. The Secretary of State for Health and Social Care has a duty under the Autism Act 2009 to publish a strategy for meeting the needs of autistic adults in England, and to review it from time to time. This document sets out a revised governance model to oversee implementation of the Strategy that centres on 19 overarching strategic objectives. These have been grouped into five domains: Measuring, understanding and reporting the needs of people with autism; Workforce development; Health, care and wellbeing; Specific support; and Participation in the local community. There will be five Task and Finish Groups, one for each domain, which will be responsible for coordinating the delivery of the relevant objectives, and tracking progress of the associated actions.

Service specification: integrated mental health service for prisons in England. This service specification describes a prison based integrated mental health service and replaces the earlier specification published in 2013.

The Improving Access to Psychological Therapies (IAPT) pathway for people with long-term physical health conditions and medically unexplained symptoms. From April 2018 all CCGs are expected to expand IAPT services integrated into physical health care pathways. This document supports this expansion by setting out the treatment pathway that underpins the access and waiting time standards, which all services should seek to measure themselves against.

Maintaining momentum: driving improvements in mental health care. This PHSO report highlights five common failings in specialist mental health services in England, and the devastating toll these take on patients and their families. The report’s findings provide fresh impetus to deliver on the recommendations set out in the Five Year Forward View for Mental Health and reinforce conclusions made by the Care Quality Commission in its 2017 report.

Final Government Response to the Law Commission's review of Deprivation of Liberty Safeguards and Mental Capacity. The Government has published its final response to the Law Commission’s report on DoLS (March 2017). It agrees in principle that the current DoLS system should be replaced with the Commission's proposed Liberty Protection Safeguards model as a matter of pressing urgency. It states that it will engage further with stakeholders particularly on implementation, and will bring forward legislation to implement the model when parliamentary time allows.

Dementia-friendly dentistry: Good practice guidelines. The FGDP has published guidance for dental professionals to help them understand dementia and its implications for dental practice, and to adapt their patient management and clinical decisions accordingly.

Cases

In the matter of  (1) LB (2) SHC sub nom NHS Dorset Clinical Commissioning Group v (1) LB (By her litigation friend the official solicitor) (2) SHC (By his litigation friend the official solicitor)  [2018] EWCOP 7 No order as to costs was appropriate where an NHS commissioning group had brought four test cases seeking clarification on the law on deprivation of liberty for mentally incapacitated adults and then withdrawn them, as it had been reasonable to raise and pursue the issue and then abort it in light of developments in the litigation.

Ali v (1) Heart of England NHS Foundation Trust (2) G4S Secure Solutions UK Ltd [2018] EWHC 591 (Ch). A mere witness, namely someone who merely gave information to the proper authority on which it could act or not, was not liable for false imprisonment even if the information provided was wrong.

R v Edward; R v Knapper; R v Payne; R v Langley [2018] EWCA Crim 595. The court summarised the general principles to be considered by those representing and those sentencing offenders with mental health problems that might justify a hospital order under the Mental Health Act 1983 s.37 and s.41, a finding of dangerousness and/or a s.45A order.

Cash v Court of First Instance, Strasbourg, France [2018] EWHC 579 (Admin). It would be unjust and oppressive to extradite an individual with serious mental illness to France in circumstances where he was unfit to stand trial and the prognosis for when, if ever, he would become fit to stand trial was uncertain. Given that uncertainty, the extradition order was discharged under the Extradition Act 2003 s.25, rather than adjourned. Although there was a presumption that an EU Member State could provide adequate health care, in some circumstances specific evidence was needed, and the requesting state was unable to put forward any information as to what the position would be.

NHS Dorset Clinical Commissioning Group v LB [2018] EWCOP 7. Application for costs by the OS after a test case relating to DoLS was withdrawn. Application refused.

Re JMK [2018] EWCOP 5. A continuing power of attorney made in Canada had not been through any court process and was not subject to a system of registration. Therefore, it did not fall within the general understanding of the term "protective measure" within the Mental Capacity Act 2005 Sch.3 and could not be recognised in England and Wales.

ET v JP & Ors [2018] EWHC 685  The meaning of s.1(3) of the Variation of Trusts Act 1958 had to be interpreted so that a decision could be made as to whether an application for a variation of a trust, one of whose beneficiaries was a 10 year autistic boy, should be heard in the High Court or the Court of Protection.

Secretary of State for the Home Department v Skripal [2018] EWCOP 6. Application by the Home Office for personal welfare orders to authorise collection and testing of blood samples and disclosure of medical records where the two patients were unconscious following a suspected nerve agent attack.

Re SW (No 2) [2017] EWCOP 30. ​​The Patient's son was seeking a Declaration from the Court, under its inherent jurisdiction, that it shall be unlawful for HMRC (the Respondent) to effect forced entry of the property of P or to restrict P's liberty of movement without permission from the Court of Protection. The application was struck out by the DJ and the son appealed.

Consultations

Proposal to amend the Tribunal Procedure (First-tier Tribunal) (Health, Education and Social Care Chamber) Rules 2008 in relation to pre-hearing examinations, and decisions without a hearing in the case of references by the hospital or Department of Health. A Tribunal Procedure Committee consultation seeks views on proposals to change the way that the First-Tier Tribunal operates in relation to mental health cases under the Mental Health Act 1983. Comments by 14 June 2018.

News

Official Solicitor loses bid for costs over withdrawn deprivation of liberty test cases. The Official Solicitor has failed to recover costs in the Court of Protection from the NHS Dorset Clinical Commissioning Group, which withdrew test cases aimed at seeking clarification of the law concerning the deprivation of liberty of mentally capacitated adults. Baker J said he did not consider it an appropriate case for an order for costs as he did not accept the suggestion that "this was not a typical welfare case" but that the application concerned cases "in which an important preliminary issue arose on a point of law".

Southern Health fined £2m over deaths of two patients. An NHS trust that admitted failing two patients who died in its care, one in a bath, has been fined £2m.

Bevan Brittan Updates

PL (by her litigation friend, SL) v Sutton Clinical Commissioning Group and Another [2017] EWCOP 22. This case follows on from the series of cases considering intensive care treatment and deprivation of liberty (Ferreira, Briggs, M and Y). It will be of interest to commissioners, providers and care co-ordinators involved with patients receiving palliative care.

Children - which decision counts? This article has been updated to take account of the President of the Court of Protection's decision in Re A-F (Children) [2018] EWHC 138 (Fam) and the decision in T (A Child: Care Order: Beyond Parental Control: Deprivation of Liberty: Authority to Administer Medication) [2017] EWFC B1.

T (A Child: Care Order: Beyond Parental Control: Deprivation of Liberty: Authority to Administer Medication) [2017] EWFC B1. - Case summary

Re A-F (Children) [2018] EWHC 138 (Fam) - Case summary.

SOSJ –v- MM & Welsh Ministers –v- PJ [2017] EWCA Civ 194. - Case summary

Commissioners, providers and care co-ordinators may be aware that NHS England has issued a briefing note on the Court of Appeal's judgement on the joined cases of SOSJ –v- MM & Welsh Ministers –v- PJ [2017] EWCA Civ 194. We have produced a Case Summary, which summarises the two cases and the briefing note – and provides our own view on the "Practical Impact".

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:-  

  • Mental Health Update - Tuesday 8 May 12.30pm - 2pm. Paul Barber continues his overview of the MHA 1983 and overlap with the MCA. This session focuses on managing the patient when detained.

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.  

CCTV KNOWLEDGE PACK

Our team has prepared a comprehensive knowledge pack which offers commissioners, providers and care co-ordinators, using CCTV in care environments, with service users who lack capacity to consent to their care regime. This CCTV in care packages knowledge pack contains:-

  • A comprehensive explanation of the legal frameworks and guidance applicable to the use of CCTV
  • The practical steps that need to be taken to ensure that there is compliance with legal frameworks
  • A quick reference checklist
  • Specific guidance in relation to adults, young persons and children. 

If you would like to buy this knowledge pack or would like more information please contact Hannah Taylor.

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

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Primary Care 

Publications/Guidance 

The state of care in independent online primary health services. This report finds that the quality of online primary care services, such as those that provide GP consultations and prescriptions through independent websites and apps, has improved over the past 12 months but further action from providers and the wider system is needed to ensure they are as safe as general practice in physical premises.

Conditions for which over the counter items should not routinely be prescribed in primary care. This guidance advises CCGs on conditions for which over the counter items should not routinely be prescribed in primary care; it should be taken into account in formulating local policies, and reflected in prescribing practice. The guidance is accompanied by a report which outlines the findings of a public consultation on these measures.

National bodies agree on shared view of quality for general practice. The 11 national organisations who together are responsible for the regulation and oversight of general practice in England have published a joint view of the principles that define quality in general practice. This national strategy will form the basis for defining quality measures and best practice.

Summary of 2018/19 General Medical Services agreement. NHS Employers and BMA’s General Practitioner Committee have agreed changes to the General Medical Services (GMS) contract effective from 1 April 2018. This document gives a summary of the 2018/19 GMS contract agreement. The investment will provide a 1% uplift to pay and a 3% uplift to expenses in line with consumer price index inflation. A further uplift may be made following the Government’s response to any recommendations by the Review Body on Doctors’ and Dentists’ remuneration, which is expected in May 2018. There are further key changes relating to use of the Electronic Prescription Service (EPS) and NHS e-Referral Service (e-RS), as well as contractual changes around advertising, violent patients, patient access to online services and out of hours services.

Dementia-friendly dentistry: Good practice guidelines. The FGDP has published guidance for dental professionals to help them understand dementia and its implications for dental practice, and to adapt their patient management and clinical decisions accordingly.

Stop smoking interventions and services. NICE and Public Health England have published updated guidelines on the best ways to help people quit smoking. This guideline covers stop smoking interventions and services delivered in primary care and community settings. It aims to ensure that everyone who smokes is advised and encouraged to stop and given the support they need. It emphasises the importance of targeting vulnerable groups who are heavy smokers or have difficulty with smoking cessation.

If you wish to discuss any mental health issues please contact Vincent Buscemi

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Procurement 

Publications/Guidance 

National bodies agree on shared view of quality for general practice. The 11 national organisations who together are responsible for the regulation and oversight of general practice in England have published a joint view of the principles that define quality in general practice. This national strategy will form the basis for defining quality measures and best practice.

News

Pioneering price match scheme frees up millions for frontline care. Highlights how the clinician-led South Yorkshire Integrated Care System has create a pioneering 'price match' scheme that drives down the cost of simple items such as anti-embolism stockings and surgical gloves. 

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

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Providers 

Publications/guidance

Planning, assuring and delivering service change for patients. This guidance is designed to be used by those considering, and involved in, substantial service change to navigate a clear path from inception to implementation. It will support commissioners and providers to consider how to take forward their proposals, including effective public involvement, enabling them to reach robust decisions on change in the best interests of their patients.

NHS Cervical Screening Programme: the role of the cervical screening provider lead. Guidance from Public Health England includes information for cervical screening provider leads on requirements of the role, accountability, working relationships, and roles and responsibilities.

Consultations

Review into NHS overseas visitor charges: call for submissions. The DHSC is reviewing the impact of changes to regulations on recovering the cost of health treatments provided to overseas visitors. It is asking organisations to submit information or experiences that are relevant to the review. The closing date for submissions is 1 June 0218.

News

CQC announces its regulatory fees for providers for 2018/19. Following a public consultation last year, the CQC have outlined the fees that providers of health and adult social care in England will pay from April 2018 to cover the costs of their regulation. We made proposals that affected NHS trusts, NHS GPs and community social care providers

NHS gets funding green light for new buildings, wards and beds. Announces that 40 NHS hospitals and community services are get £760m to modernise and transform their buildings and services. The Shropshire, Telford and Wrekin STP will receive £300m to transform local hospital services. It proposes to use the funding to develop an emergency care site and a separate planned care site, with 24-hour urgent care centres at both sites and Somerset will receive £79.4m. The remainder of the money will be awarded to 38 smaller projects. 

Bevan Brittan Events

Key Topics for Social Care Providers. Bevan Brittan is a leading law firm advising providers across the whole social care spectrum. We have specialist insight into the challenges and opportunities for the sector arising from political policy, funding and financing, innovation, new models of care, workforce issues and regulation. We have invited industry experts to join us in reviewing and debating the current hot topics for social care providers:-
Bristol Wednesday 02 May 2018, 16:00
Birmingham Wednesday 09 May 2018, 09:30
London Wednesday 16 May 2018, 09:30 

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

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Public Health 

Publications/Guidance 

Stop smoking interventions and services. NICE and Public Health England have published updated guidelines for health practitioners and stop smoking services on the best ways to help people quit smoking. The new guideline, which covers stop smoking interventions and services delivered in primary care and community settings for everyone over the age of 12, aims to ensure that everyone who smokes is advised and encouraged to stop and given the support they need. It emphasises the importance of targeting vulnerable groups who find smoking cessation hard or who smoke a lot and recommends prioritising specific groups who are at the highest risk of harm from smoking, such as women who are pregnant and people with mental health problems.

Public health commissioning in the NHS 2018 to 2019. This agreement sets out the arrangements under which the Secretary of State delegates responsibility to NHS England for certain public health services (known as Section 7A services). The services currently commissioned in this way are: national immunisation programmes; national cancer and non-cancer screening programmes; Child Health Information Services (CHIS); public health services for adults and children in secure and detained settings in England; and sexual assault services (Sexual Assault Referral Centres).

Housing and health: Opportunities for sustainability and transformation partnerships. This short report from the King's Fund, supported by the National Housing Federation, is intended to help those leading and contributing to STPs and emerging integrated care systems (ICSs) to make the most of the contribution that housing can make to health as they deliver and continue to develop.

News

Minimum unit price for alcohol to be 'major part' of efforts to reduce alcohol-related harm – Vaughan Gething. The Welsh Health Secretary has announced extra investment in substance misuse services, with ring-fenced funding for health boards increased by nearly £1m, to over £18m from 2018-19. A minimum unit price will be introduced 12 months after the Public Health (Minimum Price for Alcohol) (Wales) Bill gets Royal Assent, as a major part of a wider package of measures to reduce the harms caused by excessive alcohol consumption in Wales.

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

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Regulation 

Publications/Guidance

NMC calls for misconduct cases against nurses to be held in secret. The Nursing and Midwifery Council (NMC) has set out proposals, which are go out to consultation in April 2018, that will ensure that nurses and midwives will rarely be subject to public misconduct hearings and that they could avoid any sanctions for errors if they admit blunders early, including in cases which resulted in patient deaths. The NMC receives more than 5,000 referrals a year from hospitals, patients and the public. 

Cases

Fernando v General Medical Council (2018). The Medical Practitioners' Tribunal had been entitled to erase a doctor from the register following a finding that his fitness to practise had been impaired due to serious misconduct where he had obtained his wife's confidential medical records whilst in New Zealand and been involved in a violent offence without disclosing either matter to the GMC. The decision that erasure was the only possible sanction was proportionate and the tribunal had taken into account all relevant mitigation.

Warren v Nursing & Midwifery Council (Unreported, Admin Ct). The court ruled that the Nursing Midwifery Council's Conduct and Competence Committee had been right to find that sex with a former patient who was a recovering drug addict amounted to misconduct and to impose a 12-month suspension on the nurse in question. Its decision had been adequately reasoned and its findings of fact accurate.

Fopma v General Medical Council (Unreported, Admin Ct). The court ruled that the GMC's Medical Practitioners' Tribunal had been entitled to find that a doctor's serious professional misconduct impaired his fitness to practise and that erasure from the register was the most appropriate sanction, where the doctor had dishonestly said that he had no convictions when applying to join the GMC specialist register, but he had in fact been convicted in the Netherlands of sexually touching a patient.

News

New GMC survey questions ask doctors about burnout. As part of this year’s national training surveys, the GMC will ask a series of questions around wellbeing and the impact tiredness and workload have on both doctors in training and those training them. The new questions, which are voluntary, cover issues such as work-life balance, tiredness during and after work and the effect this may have on a doctor.  

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

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Social Care 

Publications/Guidance 

Adult social care funding: a local or national responsibility? This report argues that ongoing reforms to local government finance risk a growing funding gap for adult social care and conflict with efforts to provide consistent and high-quality care services across the country.

Reforming social care is about more than funding. This blog by Simon Bottery, Senior Fellow at the King's Fund, looks at Jeremy Hunt’s recent speech setting out his principles for social care reform and considers how the forthcoming Green Paper is now to combine them in a coherent, comprehensive plan.

We need to do better on social care. The Health Secretary has outlined the seven key principles that will guide the Government's thinking ahead of the Social Care Green Paper, which will be published in summer 2018. Central to all of these principles is innovation. He states that the current charging system for social care is far from fair and a new system needs to include an element of risk-pooling. The Green Paper will look at how to do this, as well as the potential costs.

Integrating mental health and social care: does it work in practice? This briefing looks at the integration of mental health services and social care, the benefits behind this and the challenges faced on the ground. It argues that the current pressures on both the health and care systems can conceal the day-to-day challenges of living with mental health problems, the distress of families and friends, and the struggle to stay well in their community. This briefing is free to download but requires free registration for full access.

Consultations

A consultation on extending legal rights to have for personal health budgets and integrated personal budgets. Seeks views on giving more people the right to have personal health budgets and integrated personal budgets. The consultation closes on 8 June 2018.

News

New requirements to ensure care workers are treated fairly come into force. Announces that new requirements to ensure care staff who look after people in their own homes are treated fairly and people receiving care experience the best possible services came into force on 2 April 2018.

Bevan Brittan Updates

Will Jeremy Hunt's principles for social care reform be a game changer for the sector? In his first significant speech since taking on the dual roles of health and social care, Secretary of State Jeremy Hunt outlined the seven key principles of reform to the adult social care system in England that will form the backbone of a Green Paper to be launched this summer.  

Bevan Brittan Events

Key Topics for Social Care Providers. Bevan Brittan is a leading law firm advising providers across the whole social care spectrum. We have specialist insight into the challenges and opportunities for the sector arising from political policy, funding and financing, innovation, new models of care, workforce issues and regulation. We have invited industry experts to join us in reviewing and debating the current hot topics for social care providers:-
Bristol Wednesday 02 May 2018, 16:00
Birmingham Wednesday 09 May 2018, 09:30
London Wednesday 16 May 2018, 09:30 

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

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General 

Publications/Guidance 

NHS (Pharmaceutical and Local Pharmaceutical Services) Regulations 2013: post-implementation review. This report presents the results of the statutory post-implementation review of the NHS (Pharmaceutical and Local Pharmaceutical Services) Regulations 2013. The review finds that the regulations have largely achieved the original policy objectives, which remain relevant and appropriate for the regulation of NHS pharmaceutical services in England. The review makes a number of recommendations.

Healthcare education funding for postgraduate, dental hygiene and dental therapy students. This guidance explains how new postgraduate pre-registration nursing, midwifery, allied health professional, and most new dental hygiene and dental therapy students will access loans from the Student Loans Company from 1 August 2018.

Brexit: medicines, medical devices and substances of human origin: Fourth Report of Session 2017-19. A Health and Social Care Committee publication welcomes the Government's stated intention to maintain regulatory alignment with the European Medicines Agency, and recommends that the UK should seek to continue to be a member of EU Research and Development funding and research mechanisms such as Horizon 2020 after leaving the EU, if possible on the same terms as it currently enjoys.

The public finances: a historical overview. The past 300 years have seen major changes in the way Britain handles its public finances. This briefing paper looks at trends in public income, spending and debts during this time, and comments on how the money was raised, spent and scrutinised by parliament.

Barriers to uptake of minimal access surgery in the United Kingdom. Minimal access surgery can offer improved recovery prospects for patients, but uptake in the UK is variable across both procedures and hospitals. This report assesses the benefits of minimal access surgery, the extent to which these benefits are realised in practice, and the major barriers to wider adoption.

International comparisons of health and wellbeing in early childhood. This report presents data on health and wellbeing for early childhood in the UK and 14 comparable countries, recognising the particular influence that a child’s development in this period can have on his or her future health and quality of life. It considers the benefits and challenges of comparing child health indicators between countries, with the aim of informing local and national policy and practice that improves the health of children and families in this country.

Sustainability and transformation in the NHS: Twenty-Ninth Report of Session 2017-19. A Committee of Public Accounts report calls on the Department for Health and Social Care to set out plans to secure a long-term funding settlement for the NHS, after finding that the department has not yet assessed the impact on patients or services of repeatedly raiding its capital budget to fund the NHS' short-term needs. It states that the Government should identify successes in its piloting of new care models and ensure best practice is shared across the UK.

Brexit impact must be central to workforce plan. The General Medical Council has urged workforce planners to seriously consider the impact of Brexit while developing a new strategy for the NHS, to ensure systems can cope in the face of great change.

Drug misuse prevention. This quality standard covers the prevention or delay of harmful use of drugs by children, young people and adults most likely to start using drugs, or already experimenting or using drugs occasionally. It sets out what high-quality care should look like and describes priority areas for improvement.

Brexit: reciprocal healthcare. This report argues that in the absence of an agreement on reciprocal health care, the rights of UK citizens to hold an European Health Insurance Card for treatment in the EU will cease after Brexit.

NHS workforce race equality standard: 2017 data analysis report for national healthcare organisations This report outlines the experience of black and minority ethnic (BME) staff working for six NHS arm's length bodies. It finds that whilst there are some gaps in available data to understand race equality issues across the health service, BME people are under-represented at senior levels in the six organisations and more likely to enter into disciplinary processes than white members of staff.

Gender pay report. This report provides details of NHS England’s gender pay gap under the requirements of the Equality Act 2010 Act (Gender Pay Gap Regulations) 2017 and details the six specific measures and the work that is being undertaken to address the gap.

Planning, assuring and delivering service change for patients. This guidance is designed to be used by those considering, and involved in, substantial service change to navigate a clear path from inception to implementation. It will support commissioners and providers to consider how to take forward their proposals, including effective public involvement, enabling them to reach robust decisions on change in the best interests of their patients.

Pharmaceutical companies to pay £33m of profits to NHS. Under new rules that come into effect from 1 April 2018, the Government is to claw back up to £33 million a year by requiring manufacturers of all branded medicines to return almost 8% of the net income from sales to the NHS, where at present, only companies that have opted in to a voluntary scheme that seeks to control the costs of branded medicines have to make the payment.

NHS England Funding and Resource 2018/19: Supporting 'Next Steps for the NHS Five Year Forward View'. This document contains information about NHS England’s funding in 2018/19. It also sets out how NHS England will, through the distribution of funding, people and resources, support ‘Next Steps’ to transform local health and care systems.

Sustainability and transformation in the NHS. The Commons' Public Accounts Committee finds that despite a rescue fund worth £1.8b in 2016–17, the financial position of the NHS remains in a perilous state. The NHS is still very much in survival mode, with budgets unable to keep pace with demand. DHSC, NHS England and NHS Improvement are too focused on propping up the system and balancing the books in the short term and have not paid enough attention on transforming and improving patient services in the long term. With trusts forecasting a deficit of over £900 million in 2017–18, the NHS still has a long way to go before it is financially sustainable.

Brexit: Reciprocal healthcare. The Lords' EU Home Affairs Sub-committee has found that the UK's decision to leave the EU could have a significant impact on the UK’s access to EU reciprocal healthcare arrangements. In the absence of an agreement on reciprocal healthcare, the rights of UK citizens to hold an EHIC card for treatment in the EU will cease after Brexit. The Committee's report examines the draft Brexit agreements drawn up by the UK and the EU, and assesses the extent to which they address the concerns raised by witnesses.

Brexit: medicines, medical devices and substances of human origin: Fourth Report of Session 2017-19. A Health and Social Care Committee publication welcomes the Government's stated intention to maintain regulatory alignment with the European Medicines Agency, and recommends that the UK should seek to continue to be a member of EU Research and Development funding and research mechanisms such as Horizon 2020 after leaving the EU, if possible on the same terms as it currently enjoys.

NHS mandate 2018 to 2019. DHSC has published its mandate to NHS England for 2018/19 that sets the Government's objectives and goals for NHS England to 2020, as well as some specific things that NHS England should be seeking to deliver in the financial year 2018 to 2019.

NHS Improvement's remit for 2018 to 2019. This remit letter sets out the strategic objectives for the organisation around: NHS budget; delivery of safe, high quality care; NHS operational performance; alignment with the Five Year Forward View; and NHS leadership. The letter sets out the role of NHS Improvement, working with others to provide sustainable, continually improving healthcare for all.

Wholly owned subsidiaries in the NHS. NHS Providers have published a briefing note on wholly owned subsidiaries set up by NHS trusts. It gives an overview of their history, why and how they are set up, as well as outlining the benefits they bring. It also sets out how trusts are managing the issues associated with this type of organisational form. The briefing comments that criticisms suggesting they are being used to avoid VAT or as a backdoor to privatisation are "inaccurate and misleading".

News

Guernsey to vote on making suicide clinics legal. Guernsey could become the first place in the British Isles to have a suicide clinic under proposals being put to a vote on the island in May 2018, which would apply to terminally-ill adults who are mentally competent and have been given six months or less to live. If approved, a legal framework on the changes will take place over an 18-month consultation period.

Government announces that NHS whistle-blowers will be protected from discrimination. The Government is to announce that NHS whistle-blowers will be legally protected from discrimination when applying for another job in the health service, meaning they will not be penalised for previously speaking out about potential risks to patient safety. The changes were a key recommendation in Sir Robert Francis's Freedom to Speak Up review, which found that NHS staff who blew the whistle on sub-standard and dangerous practices were being ignored, bullied or even intimidated in a "climate of fear". Under the new regulations, NHS employers will face tough penalties if applicants' complaints are upheld. 

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

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