Health and Social Care Update - May 2018

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

16/05/2018

Claire Bentley

Claire Bentley

Associate

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

Procurement

Clinical Risk/Patient Safety

Providers

Commissioning

Public Health

Employment/HR

Regulation

Independent Healthcare

Social care 

Information sharing/data

General

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

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 session coming up is:-  

  • Litigants in person and clinical negligence. 5 June 2018

Cybersecurity
Bevan Brittan Digital Health Forum: Cybersecurity - Exploring some of the lessons learned from the Wannacry attack and successfully managing risks. Bevan Brittan's quarterly Digital Forum is part of a series of events bringing together providers, consumers, industry leaders and regulators operating in the health and care sector to share views and discuss key issues and emerging themes within the digital health tech space. 20 June 2018

Procurement Updates
Birmingham - 25 June
London - 13 June
Leeds - 27 June
Bristol - 28 June

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 

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 

The state of care in independent acute hospitals. This publication presents findings from CQC's programme of inspections of independent acute hospitals. The report reveals that much of the care and treatment at independent acute hospitals is good. Effective leadership at a local level, good staff engagement and a close oversight of the services being provided play a key role in ensuring high quality care. However, the inspections also identified concerns around the safety and leadership of some services, often as a result of a lack of safety checks and poor monitoring of risks. Too often, safety was viewed as the responsibility of individual clinicians, rather than a corporate responsibility supported by formal governance processes. Where the CQC found failings, it has been clear that improvements must be made, and it will use its enforcement powers where necessary to protect people.

Allied Health Professions (AHPs) supporting patient flow. This quick guide from NHS Improvement demonstrates how NHS emergency care, in particular patient flow through the health and care system, benefits from allied health professionals (AHPs).

Paramedic prescribing. Information on changes in legislation which mean that advanced paramedics will be able to prescribe medicines to patients. This is likely to happen in practice in early 2019.

News

Ambulance trusts are seeking tens of millions of pounds in additional funding to meet new response targets and to cope with increasing demand

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 

Vulnerable children and social care in England: a review of the evidence. New research from the Education Policy Institute (EPI) examines the state of the children’s social care system in England. It brings together the latest data on children in need, intervention rates, staffing levels and funding provision.

The Government's Green Paper on mental health: failing a generation. A House of Commons Education Committee and House of Commons Health and Social Care Committee publication responds to the Department for Education and the Department of Health and Social Care's Green Paper on Transforming Children and Young People's Mental Health Provision. It highlights concerns including that: the narrow scope does not take several vulnerable groups into account, and the proposals put significant pressure on the teaching workforce without guaranteeing sufficient resources; and there is little or no attention to prevention or early intervention.

Capacity to litigate in proceedings involving children. A Family Justice Council document sets out practical guidance to assist judges in the Family Court to resolve mental capacity issues concerning parties to family law proceedings. The document may also be of use to lawyers instructed in family proceedings.

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  

Retrospective review of use of mesh or tape for urogynaecological surgery A number of patient groups have reported complications following procedures using vaginal tape or mesh. This report has been produced as a response to a call for a review of data and information to increase understanding of the number of patients who have undergone such procedures and patients' subsequent interactions with the NHS.

NHS Digital publishes statistics on vaginal mesh procedures. NHS Digital has published experimental statistics on patients that have had a procedure for urogynaecological prolapse or stress urinary incontinence including those where mesh, tape or their equivalents have been used.

Freedom to Speak Up: guidance for NHS trust and NHS foundation trust boards Effective speaking up arrangements protect patients and improve the experience of NHS workers. This guidance contributes to the need, set out by Sir Robert Francis in his Freedom to Speak Up review, to develop a more open and supportive culture that encourages staff to speak up about any issues of patient care, quality or safety. The accompanying self-review tool supports the standards laid out in the guidance. It supports trusts' review around the eight key lines of enquiry set out in the well-led framework.

Parliamentary and Health Services Ombudsman (PHSO) annual scrutiny 2016–17. This report by the HC Public Administration and Constitutional Affairs Committee scrutinises the work of the PHSO in 2016-17. Although it covers the NHS complaints system, the committee also concludes that the Government needs to take action to investigate cases of historic injustice properly and modernise the legislation for all of England's Ombudsman services. It finds that many of the challenges the PHSO faces are made harder by the Government’s slow progress on reforms to the complaints system. The Committee calls on the Government to accelerate the draft Public Service Ombudsman Bill that modernises the Ombudsman services by setting up a joint committee to conduct the pre-legislative scrutiny of the draft Bill as soon as possible. In its response to this report, the Government should provide the PHSO and LGSCO with a date by which it intends to have the new legislation in place, to allow them to plan with some confidence.

Patient safety: letter to independent healthcare providers. Health and Social Care Secretary Jeremy Hunt's letter to chief executives of independent healthcare providers ordering urgent action to improve patient safety.

Cases  

Harrap v Brighton & Sussex University Hospitals NHS Trust [2018] EWHC 1063. This case emphasises the necessity of taking adequate witness statements. If a full proof of evidence is not taken this can amount to unreasonable conduct and may have costs consequences.

Calderdale & Huddersfield NHS Foundation Trust v Sandip Singh Atwal [2018] EWHC 961 (QB) Allegations of contempt of court were found proved against an individual who had fraudulently exaggerated the continuing effect of comparatively minor injuries which were negligently treated at a hospital.

Evans v Alder Hey Children's NHS Foundation Trust [2018] EWCA Civ 805. An application for habeas corpus, by the parents of a terminally ill and catastrophically brain-damaged child, so they could remove him from a hospital which the High Court had directed to withdraw artificial ventilation and provide only palliative care, was misconceived. The child had not been deprived of his liberty and the parents did not have an unfettered right to make decisions for him which the High Court had already determined were not in his best interests. Those best interests were paramount.

Alfie Evans: European court of human rights decision. The European Court of Human Rights (ECtHR) has refused to intervene in the case of Alfie Evans, whose parents lost their legal fight in the Court of Appeal to take their young son, who has a degenerative brain disease, to Rome for treatment against the advice of UK doctors who argued that life support should be withdrawn.

News  

New system launched to help measure and prevent medication errors. The system will link prescribing data in primary care to hospital admissions to help the NHS monitor and prevent errors.

Hunt warned over private hospital safety after NHS patient death

NHS implements "novel protocol" to speed mesh implant claims. The NHS has adopted a protocol to deal with medical negligence cases involving complications following mesh implant surgery. Anticipating further claims relating to the surgeon Anthony Dixon, the NHS protocol operates as a form of alternative dispute resolution. Amy Hughes of Fletchers Solicitors said the protocol will reduce costs to the NHS, whilst ensuring claims are dealt with quickly for claimants.

NHS found liable for brain damage after not telling refugee mother how to feed baby. The family of a child who was brain damaged after hospital staff did not explain the importance of feeding a newborn have won their personal injury claim at the High Court, where a baby delivered by caesarean section at King George Hospital in Goodmayes, northeast London, in July 2009 to parents who were Tamil refugees from Sri Lanka who spoke very little English, had not been fed for more than 15 hours.

Government "to remove obstacles" to greater take-up of PPOs. The Government will try to remove "avoidable obstacles" stopping the greater use of periodical payment orders (PPOs), Ministry of Justice spokesman Lord Keen told the Association of Personal Injury Lawyers' annual conference on 17 April 2018. He added that the Government "is fully committed to the 100% compensation principle" and that the evidence the Ministry of Justice has gathered "demonstrates that the current approach to setting the rate does not reflect the actual investment behaviour of claimants, and this is resulting in systemic over-compensation".

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 session coming up is:-  

  • Litigants in person and clinical negligence. 5 June 2018

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

The interface between primary and secondary care: Key messages for NHS clinicians and managers. Good organisation of care across the interface between general practice and secondary care providers is crucial in ensuring that patients receive high-quality care and in making the best use of clinical time and NHS resources in both settings. This briefing document describes the key national requirements which clinicians and managers across the NHS need to be aware of. These are set out in the new NHS Standard Contract for 2017-19, under which clinical commissioning groups (CCGs) commission health services from providers, which came into effect on 1 April 2017 and which will remain in place until 31 March 2019.

National framework for NHS continuing healthcare and NHS-funded nursing care This guidance sets out the principles and processes of the national framework for NHS continuing healthcare and NHS-funded nursing care. Clinical Commissioning Groups (CCGs) have until October 2018 to adopt the new rules.

Developing new models of care in the PACS vanguards: a new national approach to large-scale change? This independent report was commissioned by NHS England as part of a package of support provided to primary and acute care system (PACS) vanguard sites by the King’s Fund. The PACS model is an attempt to bring about closer working between GPs, hospitals, community health professionals, social care and others. The report is not an evaluation of the PACS model or of the new care models programme, but it offers a unique set of first-hand perspectives into the experience of those leading a major programme at the national level and those living it at the local level.

PSNC Briefing 022/18: Building a business case for a Minor Ailment Service. PSNC is developing template toolkits for a range of locally commissioned services, the first of which is for Minor Ailment Services. The toolkit contains a number of resources to assist with the commissioning of a service, e.g: a costing toolkit; a business case; service specification; implementation plan; and resources to notify local GP practices about the commissioning of a new service.

Change Model. NHS England has published an updated version of its model, originally developed in 2012, which provides a useful organising framework for sustainable change and transformation that delivers real benefits for patients and the public. It was created to support health and care to adopt a shared approach to leading change and transformation. The model has been refreshed and enhanced to include a PDF guide and a series of supporting diagnostic tools to use in your work, including an action planning template and a key questions template for each component of the guide

Changes to QOF 2018/19. NHS Employers and the BMA’s General Practitioner Committee (GPC) have agreed a number of changes to the Quality and Outcomes Framework (QOF) effective from 1 April 2018.

Integrated commissioning for better outcomes: a commissioning framework. This practical tool, the result of a joint project with NHS Clinical Commissioners, updates the Commissioning for better outcomes framework 2015 to better reflect the changing commissioning landscape. The resource consists of a commissioning framework and commissioning standards that support continuous improvement.

Commissioning services to meet the needs of women and girls with Female Genital Mutilation (FGM) Recommendations for commissioners to make sure services meet the needs of women and girls with FGM and to safeguard those at risk.

Public health functions to be exercised by NHS England: sexual assault referral centres. This service specification outlines the public health responsibilities that lie with NHS England in relation to the commissioning of sexual assault services.

Strategic direction for sexual assault and abuse services. This strategic document outlines how services for victims and survivors of sexual assault and abuse, in all settings within the health and care system, need to evolve between now and 2023. It sets out six core priorities that NHS England will focus on to reduce inequalities experienced.

Consultations

Supporting Research in the NHS: A consultation covering changes to simplify arrangements for research in the NHS and associated changes to the terms of the NHS Standard Contract. Seeks views on proposals for how NHS England, DHSC and the Health Research Authority, working together, will implement changes to simplify NHS research proposals to manage excess treatment costs better and to further improve commercial clinical research set-up and reporting. The consultation also sets out specific proposals for changes to the terms of the NHS Standard Contract to support implementation of these new arrangements.

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

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Employment/HR 

Publications/guidance

Retention from an organisational development perspective. Case study of how University Hospitals Bristol NHS Foundation Trust tackled the issue of staff retention from an organisational development perspective.

Freedom to Speak Up: guidance for NHS trust and NHS foundation trust boards Effective speaking up arrangements protect patients and improve the experience of NHS workers. This guidance contributes to the need, set out by Sir Robert Francis in his Freedom to Speak Up review, to develop a more open and supportive culture that encourages staff to speak up about any issues of patient care, quality or safety. The accompanying self-review tool supports the standards laid out in the guidance. It supports trusts' review around the eight key lines of enquiry set out in the well-led framework.

Equality analysis on the proposed amendments to Clinical Excellence Awards for consultant graded doctors in the NHS in England. NHS Employers and the British Medical Association proposed changes to the way NHS consultants are rewarded for their performance. This publication considers how the proposals may affect protected groups.

Legislation

The Employment Rights Act 1996 (NHS Recruitment - Protected Disclosure) Regulations 2018. The draft Employment Rights Act 1996 (NHS Recruitment – Protected Disclosure) Regulations 2018 will prevent NHS employers from discriminating against job applicants who appear to have made a 'whistleblowing' protected disclosure. This reform to the whistleblowing framework is being made in response to research which has shown that some NHS employees feel that they are 'blacklisted' within the NHS as a consequence of making a protected disclosure.

News

BMA council chair leads campaign to improve the NHS. The BMA has launched an ambitious project aimed at helping to shape the NHS of the future and rescuing the service from its 'perilous state'. BMA council chair Chaand Nagpaul is to lead a project which aims to develop a vision for what an improved health and care system could look like.

Review announced into training NHS staff to use AI and robotics. The plans are part of an independent review into the training needs of NHS staff to ensure they are equipped to give patients the latest treatments.

Plans to strengthen NHS cyber security announced. A new multi-million pound Microsoft package will ensure NHS systems have the most up-to-date software with the latest security settings.

GMC gears up to support extra international doctors wanting to work in the UK.

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 

Bevan Brittan Updates

Employment Eye April 2018

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 acute hospitals. This publication presents findings from CQC's programme of inspections of independent acute hospitals. The report reveals that much of the care and treatment at independent acute hospitals is good. Effective leadership at a local level, good staff engagement and a close oversight of the services being provided play a key role in ensuring high quality care. However, the inspections also identified concerns around the safety and leadership of some services, often as a result of a lack of safety checks and poor monitoring of risks. Too often, safety was viewed as the responsibility of individual clinicians, rather than a corporate responsibility supported by formal governance processes. Where the CQC found failings, it has been clear that improvements must be made, and it will use its enforcement powers where necessary to protect people.

Patient safety: letter to independent healthcare providers. Health and Social Care Secretary Jeremy Hunt's letter to chief executives of independent healthcare providers ordering urgent action to improve patient safety.

News

Hunt warned over private hospital safety after NHS patient death

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

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Information sharing/data 

Publications/Guidance 

Memorandum of understanding on data-sharing between NHS Digital and the Home Office. The House of Commons health and social care committee are deeply concerned that accepting the Government’s stated position would lead to sharing non-clinical data such as addresses with other Government departments. They believe that patients’ addresses, collected for the purposes of health and social care, should continue to be regarded as confidential.

Data for public benefit: balancing the risks and benefits of data sharing. This report is based on the findings from six workshops in different local authority areas across England. Three clear tests emerged for enabling public service providers to gain the social licence to share and use data more widely: that data-sharing should be purposeful, proportionate and responsible. A further five key features that a data-sharing initiative designed to deliver public benefits should be able to demonstrate were identified.

General Data Protection Regulation (GDPR) FAQs. This NHSE factsheet aims to help NHS HR departments ensure they are compliant with GDPR. From 25 May 2018, all health organisations and arm's-length bodies will need to demonstrate compliance with new General Data Protection Requirements (GDPR). The document includes where to start as a HR professional in the NHS, some explanation around key terms, what should be in a privacy notice, how long data should be kept on file and other key questions and tips.

Cyber-attack on the NHS: Thirty-Second Report of Session 2017-19 House of Commons Committee on Public Accounts. A Committee on Public Accounts report sets out, in light of the WannaCry cyber-attack on the NHS in May 2017, a June 2018 deadline for an update on costed plans for vital security investment. It identifies how and why the Department of Health and Social Care and its national bodies should take the lead in ensuring the lessons learned by the extensive disruption caused by WannaCry are quickly translated into action.

Legislation

Data Protection (Charges and Information) Regulations 2018 (SI 2018/480). These regulations, which come into force on 25 May 2018, set out the circumstances in which data controllers are required to pay a charge, and provide information, to the Information Commissioner (IC), following the introduction of the General Data Protection Regulation (GDPR) regime. They replace the previous regime under the Data Protection (Notification and Notification Fees) Regulations 2000 (SI 2000/188). The regulations set out the different charge levels for different data controllers, which are based on the income required to enable the Information Commissioner’s Office to adequately deliver on their expanding remit following the implementation of the GDPR. The charge levels have been increased from the current level of fees to reflect the increased responsibilities of data protection supervisory authorities such as the IC under the GDPR.

News

Plans to strengthen NHS cyber security announced. A new multi-million pound Microsoft package will ensure NHS systems have the most up-to-date software with the latest security settings.

If you wish to discuss any queries you may have around independent healthcare please contact Jane Bennett.    

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Mental Health

Publications/Guidance

Minimum requirements for tribunal hearings to be held in hospitals. A "hearing room is as essential to a psychiatric hospital as an operating theatre is to a surgical hospital." If hospitals do not comply with the minimum requirements or obtain a written exemption the tribunal "may consider holding its judicial hearings elsewhere".

The Government's Green Paper on mental health: failing a generation. A House of Commons Education Committee and House of Commons Health and Social Care Committee publication responds to the Department for Education and the Department of Health and Social Care's Green Paper on Transforming Children and Young People's Mental Health Provision. It highlights concerns including that: the narrow scope does not take several vulnerable groups into account, and the proposals put significant pressure on the teaching workforce without guaranteeing sufficient resources; and there is little or no attention to prevention or early intervention.

Funding supported housing for all: specialised supported housing for people with a learning disability This report estimates that the specialised supported housing (SSH) sector is more than double the size of previous estimates and that demand for SSH is rising. The research also finds that living independently with support in the community has a positive impact on wellbeing for people with a learning disability. SSH is a housing alternative for people with complex needs who might otherwise have lived in residential care, or NHS provisions such as ‘secure’ accommodation.

The independent review of the Mental Health Act: interim report. This independent review was set up to look at how the legislation in the Mental Health Act 1983 is used and how practice can improve. This interim report gives an update on the review’s findings and the areas it will look at next. It includes service user and carer surveys; focus groups; stakeholder workshops; a call for evidence; and the findings from wider discussions with organisations and professionals. The review will examine the issues as set out in the report before making its final recommendations.

The perinatal mental health care pathways. This document sets out policy drivers and strategic context for transforming perinatal mental health care, as well as pathways to deliver transformation. It provides services with evidence on what works in perinatal mental health and case studies of positive practice.

The learning disabilities mortality review: annual report 2017. The Learning Disabilities Mortality Review programme was established to support local areas to review the deaths of people with learning disabilities, identify learning from those deaths, and take forward the learning into service improvement initiatives. This annual report summarises the learning and recommendation from 103 reviews of deaths of people with learning disabilities during 2017.

Capacity to litigate in proceedings involving children. A Family Justice Council document sets out practical guidance to assist judges in the Family Court to resolve mental capacity issues concerning parties to family law proceedings. The document may also be of use to lawyers instructed in family proceedings.

Antenatal and postnatal mental health: clinical management and service guidance. This guideline covers recognising, assessing and treating mental health problems in women who are planning to have a baby, are pregnant, or have had a baby or been pregnant in the past year. It covers depression, anxiety disorders, eating disorders, drug- and alcohol-use disorders and severe mental illness. It promotes early detection and good management of mental health problems to improve women’s quality of life during pregnancy and in the year after giving birth.

Alcohol and mental health: policy and practice in England . This report highlights that people who have difficulties with alcohol and mental health are still not getting the help and support they need. It is based on a survey and seminar session held with professionals working in mental health and/or alcohol services across the country. It finds that co-morbidity is a barrier to treatment, and support for people with co-occurring alcohol and mental health problems is too often poor and fragmented.

Changes to the Personal Independence Payment eligibility criteria. On 19 January 2018 the Government announced that it accepted a High Court ruling that controversial changes made in March 2017 to the criteria for the PIP mobility component for people experiencing psychological distress were unlawful. This Commons Library briefing gives background information to the changes that have now been overturned. It will be updated in due course to take account of subsequent developments. In the meantime, this paper gives information on what the latest announcement means for PIP claimants.

Brene Brown on empathy. What is the best way to ease someone's pain and suffering? In this beautifully animated RSA Short, Dr Brené Brown reminds us that we can only create a genuine empathic connection if we are brave enough to really get in touch with our own fragilities.

Care and support of people growing older with learning disabilities. This guideline covers care and support for adults with learning disabilities as they grow older. It covers identifying changing needs, planning for the future, and delivering services including health, social care and housing. It aims to support people to access the services they need as they get older.

Dementia support guide for councils. Local authorities have a unique role to play in supporting people following a diagnosis of dementia. As well as providing care and support on a statutory basis, they have a role to lead on prevention and early intervention by promoting good health and wellbeing. They also have responsibilities to provide good quality information and advice. Local authorities have now been under sustained funding constraints for many years and continue to be so. Despite such pressures, this publication produced in partnership with the national DAA highlights some notable and innovative practice by councils in supporting people living with dementia after their diagnosis.

Bevan Brittan Mental Health Extranet

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

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

 

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Primary Care 

Publications/Guidance 

General Medical Services (GMS) - change in practice income ready reckoner from 1 April 2018. NHS Employers has published a ready reckoner to support commissioners and practices in calculating the effect of the financial changes to the GMS contract 2018/19.

Guidance on supporting information for appraisal and revalidation. The GMC has issued guidance on its requirements for licensed doctors for supporting information for appraisal and revalidation. Licensed doctors are expected to collect six types of supporting information, to reflect on and discuss at their appraisals, as part of the process of revalidation , namely: continuing professional development; quality improvement activity; significant events; feedback from colleagues; feedback from patients; and complaints awww.hsj.cond compliments.

Spotlight on the 10 High Impact Actions. This report assesses NHS England's Time for Care programme - specifically, its 10 High Impact Actions, which aim to cut workload in general practice. Every GP surgery should be funded to have access to a dedicated social prescriber in a bid to tackle crippling GP workload, and free up their time for those patients most in need of medical care, according to the report.

Developing new models of care in the PACS vanguard: a new national approach to large-scale change? The primary and acute care system (PACS) model is an attempt to bring about closer working between GPs, hospitals, community health professionals, social care and others. This report offers a unique set of first-hand perspectives into the experience of those leading a major programme at the national level and those living it at the local level. The insights shared will be invaluable to those constructing future national support programmes intended to facilitate transformation in local health and care systems.

Online consultations in general practice: the questions to ask. The Royal College of GPs has published a list of questions for patients, GPs and commissioners to consider before using or utilising online general practice services.

Transforming health care in nursing homes – An evaluation of a dedicated primary care service in outer east London. The Nuffield Trust was commissioned by the Barking and Dagenham, Havering and Redbridge CCGs to evaluate a new primary care service that was being piloted in four nursing homes in Havering that had previously had difficulty accessing GP services. The evaluation suggests that there are benefits in providing proactive primary care for nursing homes, delivered by a consistent GP within a service that specialises in older people with complex care needs. This report assesses the impact of the new service on hospital attendance, and details the experiences and views of staff in the nursing homes and health care professionals delivering the new service.

Patient Activation Measure – implementation quick guide. The Patient Activation Measure (PAM) is a tool that enables healthcare professionals to understand a patient’s activation level, or their level of knowledge, skills and confidence to manage their long term condition. This quick guide provides practical and operational support to sites considering the use of PAM licences. The guide focuses on why patient activation is important in managing people’s health and wellbeing, as well as elements to consider before implementing the PAM. NHS England recommend using the PAM in the context of a fully integrated approach to personalised care for people with long term conditions.

General Medical Services (GMS) - change in practice income ready reckoner from 1 April 2018. NHS Employers has published a ready reckoner to support commissioners and practices in calculating the effect of the financial changes to the GMS contract 2018/19.

Guidance on supporting information for appraisal and revalidation. The GMC has issued guidance on its requirements for licensed doctors for supporting information for appraisal and revalidation. Licensed doctors are expected to collect six types of supporting information, to reflect on and discuss at their appraisals, as part of the process of revalidation , namely: continuing professional development; quality improvement activity; significant events; feedback from colleagues; feedback from patients; and complaints awww.hsj.cond compliments.

Spotlight on the 10 High Impact Actions. This report assesses NHS England's Time for Care programme - specifically, its 10 High Impact Actions, which aim to cut workload in general practice. Every GP surgery should be funded to have access to a dedicated social prescriber in a bid to tackle crippling GP workload, and free up their time for those patients most in need of medical care, according to the report.

Online consultations in general practice: the questions to ask. The Royal College of General Practitioners have published new guidance on online consultations for patients and practices. The guidance includes a list of questions for patients, GPs and commissioners to consider before using or utilising online general practice services.

News
High Court judge reserves judgment in NHS and homeopathic medicines dispute. After a four-day hearing in the High Court, judgment has been reserved in the British Homeopathic Association (BHA)'s challenge to the NHS's recommendation that homeopathic medicines should not be prescribed by GPs.  

New system launched to help measure and prevent medication errors. The system will link prescribing data in primary care to hospital admissions to help the NHS monitor and prevent errors.

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

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Procurement 

Publications/Guidance 

Less waste, more health: a health professional's guide to reducing waste This report explains how health professionals can positively influence societal health and wellbeing by making simple changes to the procurement and disposal of medical supplies. It features a range of case studies and 12 recommendations setting out how everyone in the NHS can positively influence the health of patients; aid financial savings; and shape the impact of the NHS on the environment.

Procurement Policy Note 01/18: Supply chain visibility. This PPN sets out new measures to increase the visibility of subcontracting opportunities in Government supply chains and to provide greater visibility of supply chain spend. The measures include a reporting template. All Central Government Departments, their Executive Agencies and Non Departmental Public Bodies must apply the provisions of this PPN in new procurements from 1 May 2018.

Consultations

Prompt payment by Government suppliers. The CCS is seeking views from suppliers to government, their representatives, public bodies and those involved in public procurement on proposals to exclude suppliers from major government procurements if they cannot demonstrate a fair, effective and responsible approach to payment in their supply chain management. The closing date for comments is 5 June 2018.

Events

Procurement Updates

Birmingham - 25 June
London - 13 June
Leeds - 27 June
Bristol - 28 June

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

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Providers 

Publications/guidance

CQC Steve Field's column. Steve Field looks at the requirement for providers to display their CQC ratings and how they can do this.

Powerful patients, paperless systems: how new technology can renew the NHS This report proposes the Department of Health and Social Care should drive a fundamental shift in behaviour by working closely with suppliers and NHS partners. It proposes ambitious reforms to the NHS, shedding paper, pagers and fax machines to create a fully digital NHS that will help patients take control of their treatment.

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

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Public Health 

Publications/Guidance 

Strategic direction for sexual assault and abuse services. This strategic document outlines how services for victims and survivors of sexual assault and abuse, in all settings of the health and care system, need to evolve between now and 2023. It sets out six core priorities that NHS England will focus on to reduce inequalities experienced.
See also Public health functions to be exercised by NHS England – Service specification: Sexual Assault Referral Centres. This is service specification accompanies the NHS Public Health Functions Agreement 2016-17. It outlines the public health functions to be exercised by NHS England in regards to the commissioning of Sexual Assault Referral Centres (SARC).

Tackling tuberculosis: local government's public health role. This LGA document discusses how local authority staff have essential frontline roles to play in TB control – identifying symptoms, advising health and social care professionals, appropriate infection control, responding to TB incidents and outbreaks in settings such as schools, and ensuring that they themselves are also protected and screened if needed. It makes recommendations on how local authorities can tackle TB. The Annex details the burden of TB in each local authority.

Consultations

Refugee and asylum seeker health. The Welsh Government is seeking views on draft Policy Implementation Guidance that aims to improve access to healthcare and health outcomes for refugees and asylum seekers and in so doing, help to improve the cultural competence of the healthcare practitioners working with them.. The closing date for comments is 29 June 2018.

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

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Regulation 

Publications/Guidance

The changing nature of regulation in the NHS. This report outlines the results of NHS Providers' fourth regulation survey, which explores NHS trusts and foundation trusts' experiences of regulation over the preceding 12 months and their views on the future of regulation, and identifies trends over time. The findings show that the regulation of NHS trusts is not keeping pace with the move towards delivering more integrated care for patients. Just one in five trusts who responded to the survey are clear about the future direction of the health and care system regarding how providers will be regulated to ensure high quality and safe services for patients and service users. And despite investing significant time into sustainability and transformation partnerships and integrated care systems, trusts say there is a lack of clarity about what is expected from them from the regulators. This lack of clarity risks increasing the burden on trusts by duplicating regulatory activity, and is also likely to result in confusion in terms of who is responsible for holding trusts to account for quality of care and financial performance at a local system level.

Freedom to Speak Up: guidance for NHS trust and NHS foundation trust boards. NHS Improvement has published its expectations of boards and board members in relation to Freedom to Speak Up plus a self-review tool. It wants all trust boards in England to use the self-review tool to identify areas for development and improve the effectiveness of their leadership and governance arrangements in relation to Freedom to Speak Up.

Consultations

Nursing associates: Consultation on the regulation of a new profession. The Nursing and Midwifery Council is seeking views on its proposed approach to the regulation of nursing associates. This is a new role created to bridge the gap between healthcare assistants and registered nurses in England. The proposals include ambitious standards of proficiency for the role that will enable nursing associates to deliver first class care. It also sets out how the existing Code will apply to nursing associates as well as nurses and midwives, ensuring that the same high standards of professional behaviour and conduct will apply to everyone on the NMC register. The closing date for comments is 2 July 2018.

Ensuring patient safety, enabling professionalism. The Nursing & Midwifery Council has issued a public consultation on proposed changes to its fitness to practise function. The proposed approach recognises that employers are usually in the best position to resolve concerns immediately and that the NMC should only take action if the concern has already been investigated by the employer. Under the proposals, those affected by failings in care will be supported through the NMC's new public support service and will only be called to give evidence at public hearings where absolutely necessary. The closing date for responses is 30 May 2018.

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

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Social Care 

Publications/Guidance 

Vulnerable children and social care in England: a review of the evidence. New research from the Education Policy Institute (EPI) examines the state of the children’s social care system in England. It brings together the latest data on children in need, intervention rates, staffing levels and funding provision.

Six things you should expect from social care support. People have told Healthwatch that they want to feel listened to and involved in decisions about their social care. This web page lists six things that people should expect from care services, according to new NICE guidelines.

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 short-term, ring-fenced funding that has been committed to adult social care between 2016/17 and 2019/20, and outlines concerns about a social care funding gap and financial uncertainty post 2020.

Why call it care when no one cares? This Age UK campaign report looks at how older people and their families experience the crisis in social care. It summarises the results of a series of listening events that the charity held with older people who are receiving care and their family carers in which they talked about their personal experiences of care, highlighted the problems they faced and what would make life better. They also discussed various funding proposals and what those would mean for them and their families.

Care and support of people growing older with learning disabilities (NG96). This NICE guideline covers care and support for adults with learning disabilities as they grow older. It covers identifying changing needs, planning for the future, and delivering services including health, social care and housing. It aims to support people to access the services they need as they get older.

Messages on the future of domiciliary care services This paper lays out seven key areas for the sustainable delivery of domiciliary care services. It describes the importance of transparency and good working relationships between commissioners and providers as being critical in this area.

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

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General 

Publications/Guidance 

Violence against NHS staff: a special report by HSJ and Unison. This special report by HSJ and Unison investigates why reports of physical violence against NHS staff are on the rise, the importance of collating this data nationally, and what can be done to reverse the trend. The research reveals sharp increases in attacks on staff working for acute trusts, but also a levelling off in assaults within mental health settings.

News

Daryll Rowe jailed for infecting men with HIV. A man who said he was "riddled" with HIV and convicted of trying to infect 10 men has been jailed for life with a minimum term of 12 years.

Majority of voters now support tax rises to bolster NHS. According to a poll conducted by the British Social Attitudes research centre, voters are ready by nearly two to one to pay more tax to bolster the NHS. In the biggest ever shift of opinion on the issue, there was 41% support for higher taxes in 2014, which rose to 61% at the end of 2017. In addition, nearly nine in 10 people believed there was a funding crisis. The poll identifies a growing debate about the best way of raising money for the health service, with opinion divided between raising income tax, raising national insurance or bringing in a dedicated NHS tax

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

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