31/07/2020

The growing impact of the Coronavirus (COVID-19) is having an unprecedented generational impact on the health and wellbeing of society across the UK and around the world. The impact is being felt in our everyday lives and is now having far reaching consequences for everyone. If you or your organisation needs advice relating to Coronavirus, Bevan Brittan has set up a COVID-19 Advisory Service which draws upon the expertise of a range of Bevan Brittan legal and regulatory teams. Please feel free to contact us.

Bevan Brittan provides high quality, comprehensive advice to the NHS and independent healthcare sector. This update contains brief details of recent Government publications, legislation, cases and other developments relevant to those involved in health and social care work, both in the NHS and independent sector which have been published in the last month.  

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Training Events

Inquests
Acute and emergency care

Mental Health

Children/young people

Primary Care

Clinical Risk/Patient Safety

Providers

Commissioning

Public Health

Digital Health

Regulation
Employment/HR Social Care

Finance

General

Information sharing/data

 

 

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Bevan Brittan Free Training Events 

Clinical Risk Webinars
Bevan Brittan Clinical Risk/Health, Care and Regulatory Law Team Training -
These are internal hour long lunch time training sessions that are attended by our team of solicitors. If your employer organisation is a Bevan Brittan client you can sign up to watch the training sessions remotely via our webinar facility.

Webinars coming up are as follows:-
1. The interface between civil claims and inquests - 4th August 2020 12.30pm
2. A radiologists view on brain and spine catastrophic injury in clinical negligence cases. - 1st September 2020 12.30pm
3. Commercial surrogacy/foreign surrogacy 15th September 2020 12.30pm. 

Mental Health Webinars

Proposed changes to the Mental Health Act - a few observations. 13 August 09.30 - 10.15. Join us for the first in a series of important updates to the proposed changes of the new Mental Health Act. In this first webinar hosted by Simon Lindsay and Jennifer Nwachukwu we will be reviewing some of the key themes of the Wessely Report and the ideas and themes underlying its proposals. In particular, this session will look at how far recent human rights law developments are reflected in the discussion and recommendations the report makes.

Employment Webinars

UK immigration law: an overview for employers - 10 September 2020

Knowledge Transfer

Training. In addition to our free training programme for 2020 (ask Claire Bentley if you want a copy), 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.  All these sessions are available remotely via our webinar facility.

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Acute and emergency care

Publications/Guidance 

Improving medical pathways for acute care. The Royal College of Emergency Medicine (RCEM), Royal College of General Practitioners (RCGP), Royal College of Physicians (RCP) and the Society for Acute Medicine (SAM) have made recommendations for the immediate transformation of the urgent and emergency care pathway.

The impact of the Covid-19 epidemic on all-cause attendances to emergency departments in two large London hospitals: an observational study. This report aimed to assess how the reorganisation of hospital care and admission policies to respond to the Covid-19 epidemic affected emergency attendances and emergency hospital admissions. The report uses administrative patient-level clinical hospital records from two large London hospitals from Imperial College Healthcare NHS Trust (St Mary’s and Charing Cross) to analyse trends in attendances to emergency departments and emergency admissions pre- and post-implementation of lockdown policies in England.

News 

Patients to book appointments at A&E by autumn 2020. A joint board meeting of NHS England and NHS Improvement has been told that plans for patients to "call first" and book into accident and emergency (A&E) departments via NHS 111 will be implemented before December 2020 when new emergency care standards designed to replace the four-hour waiting time target would also be in place. The Royal College of Emergency Medicine and other royal colleges gave their backing in July 2020 to the four-hour target being dropped.      

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

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Children and young people 

Publications/Guidance 

Building a country that works for all children post Covid-19 The purpose of this short discussion paper is: to put children, young people and their lived experiences of Covid-19 front and centre in national recovery planning; to articulate what is needed to restore the public support services they rely on; and to capture the positives and gains made during a very complex national, and indeed, global emergency. It is clear that the pandemic, ensuing lockdown and enduring social distancing measures have simultaneously exposed and heightened the impact of stark disparities between disadvantaged children and their more affluent peers, from ill health and poor-quality housing to children’s access to technology and therefore opportunities to learn at home.

Best Beginnings: a proposal for a new early years guarantee to give all children in England the best start in life. This report looks at the provision of early years services for children across the country, alongside a warning that many nurseries are at risk of closure, hitting the life chances of some of the most vulnerable children and holding back the economic recovery following lockdown. The Children's Commissioner calls for a new Best Beginnings early years investment plan, ranging from Children and Family hubs to midwives and health visitors, to tackle these problems at the beginning of a child’s life rather than waiting until crises develop in later years.

Out of routine: a review of sudden unexpected death in infancy (SUDI) in families where the children are considered at risk of significant harm This review sets out recommendations and findings for government and local safeguarding partners to better protect infants from sudden unexpected death in infancy (SUDI). The aim is to identify what might have been done differently and how to improve approaches to embed safer sleeping advice in families with children considered to be at risk of significant harm through child abuse or neglect.

Guidance on vulnerable prisoners during Covid-19 The Parole Board has issued guidance to members on children and prisoners in secure hospitals/mental health units during the parole process.

National Child Mortality Database – Report on Child Suicide during the COVID-19 Pandemic in England The National Child Mortality Database (NCMD) responded to the COVID-19 pandemic by accelerating its notification and analysis service to develop a real-time surveillance system. This report describes findings from that system relating to death by suicide. Likely suicides occurring between 1st January – 17th May 2020 were identified from NCMD records.

Coronavirus: impact on young people with mental health needs This second survey with young people by Young Minds investigating the mental health impact of the Covid-19 coronavirus pandemic shows that many are under increasing pressure and struggling to get the right support. The report reflects the results of a survey with 2,036 young people aged 13-25 with a history of mental health problems, carried out between 6 June and 5 July. It follows on from a similar survey carried out in March, at the start of the lockdown period.

National Child Mortality Database – Report on Child Suicide during the COVID-19 Pandemic in England The National Child Mortality Database (NCMD) responded to the COVID-19 pandemic by accelerating its notification and analysis service to develop a real-time surveillance system. This report describes findings from that system relating to death by suicide. Likely suicides occurring between 1st January – 17th May 2020 were identified from NCMD records.

Tackling obesity: empowering adults and children to live healthier lives It has been known for decades that living with obesity reduces life expectancy and increases the chance of serious diseases such as cancer, heart disease and type 2 diabetes. In the past few months it has been seen that excess weight puts individuals at risk of worse outcomes from coronavirus (Covid-19). This policy paper outlines actions the government will take to tackle obesity and help adults and children to live healthier lives.

Multi-agency statutory guidance on female genital mutilation Multi-agency guidelines on FGM for those with statutory duties to safeguard children and vulnerable adults.

NICE impact: children and young people’s healthcare This report highlights progress made by the health and care system in implementing NICE guidance.

Cancer x coronavirus: the impact on young people Young people with cancer are feeling further isolated. This report reveals that they are having difficulties accessing emotional and psychological support and are finding the isolation from friends and family, school or work hardest to manage.

Guidance for those under 25 who provide care for someone. Department of Health and Social Care guidance for young carers young adult carers, which will also be helpful for those who provide services to support young people who provide care, sets out the changes they need to make during the coronavirus (COVID-19) outbreak. It covers practical advice on support on money, accessing support, food and medication, schools and education, and staying safe on the internet.

Protocols for seeing children and families and using offices during the Covid-19 pandemic. CAFCASS has published two protocols setting out its approach to returning to in-person work with children and families, and using CAFCASS offices during the COVID-19 pandemic. The first protocol deals with the use of both remote video technology and in-person visits to speak with children, and the second states that 17 CAFCASS offices will be opened from 27 July 2020 so that Family Court Advisers can safely meet with children to understand their needs and to enable them to make recommendations to the family court.

News

Almost 2,500 children admitted to hospital with malnutrition this year as cases double in England Liberal Democrat MP who obtained data says figures show need for ‘system of social security that helps everyone and makes sure no one goes hungry.’

How we can help

We can assist in relation to the statutory responsibilities for children under the Coronavirus Act 2020 including decisions around:-

  • commissioning and the provision of healthcare and social care;
  • isolation and duties toward children in the care and those classed as vulnerable under the Coronavirus ( COVID19 );
  • guidance on vulnerable children and young people;
  • the delivery of EHCP plans; 
  • safeguarding; and,
  • all aspects of educational provision including for key workers.

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 

NHS Resolution Customer Survey. The results of the NHS Resolution 2020 customer survey have been extremely positive, with 72 per cent of customers stating they were happy with the services they provide – another year-on-year increase overall. Some 96 per cent of Practitioner Performance Advice customers were satisfied with the service provided; up from 80 per cent in 2019.

Annual report and accounts 2019/20 The NHS Resolution's annual report and accounts reports on the first year of a new indemnity scheme for general practice, bringing information on clinical negligence claims against the NHS in England under one umbrella for the first time. NHSR received 11,682 new clinical negligence claims and reported incidents, a 9.3% increase; 401 of the 998 new claims and incidents came from the new indemnity scheme for general practice. The report showed that 71% of clinical claims concluded without formal proceedings.

Safety of maternity services in England Inquiry The Health and Social Care Committee has launched an inquiry into recurrent failings in maternity services and what action is needed to improve safety for mothers and babies. It will build upon investigations that followed incidents at East Kent Hospitals University Trust and Shrewsbury and Telford Hospitals NHS Trust, as well as the inquiry into the University Hospitals of Morecambe Bay NHS Trust. MPs will also consider whether clinical negligence and litigation processes need to be changed to improve the safety of maternity services, as well as the extent to which a "blame culture" affects medical advice and decision-making. Comments by 4 September 2020.

COVID-19 rapid guideline: arranging planned care in hospitals and diagnostic services The guideline emphasises the need for shared decision-making, including discussing with patients factors such as their age, sex and ethnicity that could increase their risk of getting COVID 19 and of having a severe illness, because these may influence their decision to have planned care. The guideline highlights the need for patients who are having regional anaesthetic procedures or sedation to self-isolate for between 14 days and at least 48 hours before the procedure, depending on their individual risk factors and circumstances.

First do no Harm  - The Independent Medicines and Medical Devices Safety Review Baroness Cumberlege - An Independent Medicines and Medical Devices Safety (IMMDS) Review publication makes recommendations to bring help and support to those who have suffered as a result of three medical interventions, primodos, sodium valproate, and pelvic mesh. The recommendations include: the appointment of a Patient Safety Commissioner to be the patients' port of call, listener and advocate, who holds the system to account, monitors trends, and demands action; and the creation of a Redress Agency for those harmed by medicines and medical devices in future.

Courts and tribunals tracker list during coronavirus outbreak. A tracker list of open, staffed and suspended courts during the coronavirus outbreak – regularly updated.

Disparities in the impact of Covid-19 in black and minority ethnic populations: review of the evidence and recommendations for action The question of why more people from black and minority ethnic (BME) backgrounds appear to be at greater risk of hospitalisation and death with Covid-19 – and the need for urgent action in order to address this – has become one of the most pressing issues in this pandemic in the UK. This review of the evidence suggests that the reasons why some BME groups appear to be at greater risk of dying with Covid-19 are complex, with interplay between socio-economic disadvantage in BME populations, high prevalence of chronic diseases and the impact of longstanding racial inequalities being key explanations.

Have your say in shaping the future of NHS complaint handling  A Parliamentary and Health Service Ombudsman consultation seeks views on its draft "Complaint Standards Framework: Summary of core expectations for NHS organisations and staff". Comments by 18 September 2020.

Cases

R (on the application of Antonia Iroko) (Claimant) v (1) HM Senior Coroner for Inner London South (2) HM Assistant Coroner for Inner London South (Defendant) & Lewisham & Greenwich NHS Trust (Interested Party) [2020] EWHC 1753 An inquest that complied with the procedural obligation in ECHR art.2 was not required in the case of a hospital patient who died following a cardiac arrest where, after one round of cardiopulmonary resuscitation, the registrar leading the resuscitation team had taken the clinical decision that further resuscitation attempts would be inappropriate.

Re C (A Child) [2020] EWCA Civ 987  Highly critical comments made about a party by a judge while in chambers, which were accidentally broadcast over the remote system during a break in a "hybrid" hearing in care proceedings, demonstrated a real possibility of bias which should have been resolved by recusal.

MS (A Child) v Croydon Health Service NHS Trust  [2020] 7 WLUK 474 Before a trial on quantum, a claimant was granted relief from sanctions and granted permission to serve additional expert evidence on an NHS trust. The court found that the trial date had not been jeopardised, the evidence was required to assess the claimant's needs, and permission would have been granted had the application been in time.

SC (A child suing by her mother & litigation friend AC) v University Hospital Southampton NHS Foundation Trust [2020] EWHC 1610 (QB)  An NHS Trust was liable for the injuries a child sustained when a hospital diagnosed her with tonsillitis but failed to recognise that she also had meningitis. The hospital had not addressed the meningitis symptoms identified by the child's GP or appreciated that antibiotics administered by him prior to hospital admission could have masked the development of the child's symptoms, and that the only safe way to proceed was to carry out tests to exclude other possible diagnoses.

R (on the application of Ashish Dutta) v GMC [2020] EWHC 1974 (Admin) QBD  The High Court examined the guidance and case law on assessing witness credibility. It criticised the reasoning given by the Medical Practitioners Tribunal when making findings of fact against a cosmetic surgeon and suspending him on the ground that his fitness to practise was impaired. The court also considered the "five-year" test in the General Medical Council (Fitness to Practise) Rules Order of Council 2004 Sch.1 r.4(5) and gave guidance how to interpret and apply the term "allegation".

Consultations

Consultation on draft ‘Framework for involving patients in patient safety’ As a result of COVID-19 NHS England has extended the closing date of their consultation on a draft framework for involving patients in patient safety to 18 October 2020.

Legislation

The Health Service and Social Care Workers (Scrutiny of Coronavirus-related Deaths) Directions 2020. Directions to NHS trusts and NHS foundation trusts in England to ensure the scrutiny of deaths of health service and adult social care staff from coronavirus. 

News

New claims management coding to drive improvements in maternal and neonatal care Marking the launch of the 20th international Group B Strep Awareness Month on 1 July, NHS Resolution has recently introduced a series of new learning codes to its claims management system to improve the identification of injuries suffered by babies in the neonatal period.

Personal injury claim numbers continue to fall. According to newly published figures, the amount of personal injury claims registered with the Compensation Recovery Unit (CRU) fell over 2019/20 to the lowest point in a decade, with a recorded 862,356 claims, a 3.8% drop on the previous year, of which 653,052 were motor claims, 7,556 fewer than in 2018/19. There were also significant drops in the number of public liability claims reported to the CRU in 2019/20 (72,587, down 15%) as well as employer's liability cases (79,027, down 12%), while clinical negligence claims dipped 5.7% to 15,845.

Shropshire maternity scandal: Hundreds more cases under review. Hundreds more cases are to be reviewed by an independent inquiry into maternity care at an NHS trust.

Bevan Brittan Updates

Bevan Brittan has collaborated with NHS Resolution to produce a series of videos outlining key areas in general practice that frequently give rise to claims. Members of our clinical negligence team draw on their wealth of experience in dealing with claims to highlight the common areas of risk, provide guidance on how to mitigate or avoid these issues, and what steps to take if a complaint or a claim is received. The first three videos in this series are available to watch now. See below:-
Consent - Daniel Morris
Medical record keeping - Ben Lambert
Administrative errors - Susan Trigg
To watch the other videos as they are released, follow NHS Resolution and Bevan Brittan on LinkedIn and Twitter, where we will share a new video each week.

With friends like these…McKenzie Friends - Ella Casson

First Do No Harm – What you need to know about the Cumberlege Review - Daniel Morris

Bevan Brittan Events

Bevan Brittan Clinical Risk/Health, Care and Regulatory Law Team Training - These are internal hour long lunch time training sessions that are attended by our team of solicitors. If your organisation is a Bevan Brittan client, you can sign up to watch the training sessions remotely via our webinar facility. If you would like to receive more information about our webinar programme just ask Claire Bentley. Sessions coming up are as follows:-
1. The interface between civil claims and inquests - 4th August 2020 12.30pm
2. A radiologists view on brain and spine catastrophic injury in clinical negligence cases. - 1st September 2020 12.30pm
3. Commercial surrogacy/foreign surrogacy 15 September 2020 12.30pm.

If you would like to receive the Education Lunch Programme for 2020 just ask Claire Bentley. 

How we can help

We are working with clients on formulating policies and making it easier to balance treatment with finite resources. We are helping with social care policies and day to day activities such as contact and isolation, human rights issues and life/death decisions. We are working on notifications of harm and death, RIDDOR, CQC compliance, judicial review, infection control law and grappling with the new regulations and guidance. For more information click here.

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

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Commissioning

Publications / guidance

COVID-19: guidance for commissioners and providers of services for people who use drugs or alcohol Page summary COVID-19 guidance for commissioners and service providers for those dependent on drugs or alcohol Change made Guidance updated relating to PPE supply, NHS test and trace, accessing treatment and meeting of groups inside and outside.

Commissioning out of hospital care services to reduce delays The aim of this paper is to offer health and social care organisations a coherent rationale for developing integrated strategies that can guide effective performance management, commissioning and day-to-day service delivery. At its core is the underlying principle that by focusing on achieving the right outcomes for people, tangible improvements in the effective use of resources should be seen.

Coronavirus (COVID-19): guidance for people receiving direct payments Advice for people who buy care and support through a direct payment, as well as local authorities, clinical commissioning groups and those who provide care and support.

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

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Digital Health

Publications/guidance

The impact of technology in adult social care provider services Digital Social Care (a group of organisations working to support adult social care providers) set up a helpline to provide technical help and support to providers adapting to digital platforms as Covid-19 took hold. They worked with IPC to carry out research with social care providers to help them tackle digital challenges during the pandemic and beyond. This report of the action research identifies both the challenges but also the benefits for care providers of using technology.

Technology checklist for video calling an adult or carer This checklist covers the necessary steps a social worker or practitioner should take to ensure that technology for video calling is ready and appropriate.

If you wish to discuss any queries you may have around Digital Health please contact Daniel Morris.

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Employment/HR  

Publications/guidance

Exposed, silenced, attacked: failures to protect essential workers during the pandemic. Amnesty has collated and analysed a wide range of available data showing that more than 3,000 health workers have died after contracting Covid-19 in 79 countries, though the figure is likely to be a significant underestimate due to under-reporting. According to Amnesty’s monitoring, the countries with the highest numbers of health worker deaths thus far, are: Russia (545), UK (England and Wales: 540, including 262 social care workers), USA (507), Brazil (351), Mexico (248), Italy (188), Egypt (111), Iran (91), Ecuador (82) and Spain (63). In the UK, early studies indicate that black, Asian and minority ethnic health workers appear to be significantly over-represented in the total number of Covid-19 related health worker deaths, with some reports showing that more than 60 per cent of health workers who died identified as BAME.

Supporting staff with childcare responsibilities. COVID-19 has demonstrated the difficulties and challenges that parents can face when their usual childcare arrangements reduce or cease. Research by Working Families shows that one in seven workers across the UK has had to make changes to their work pattern to balance work, childcare, and home-schooling requirements.  

New animations showcase a career in general practice A series of imaginative short animations covering the application process, flexible options and life as a GP have been developed by Health Education England (HEE) ahead of its latest GP training application round which kicks off this week.   

A new era of digital leadership. This guide published by NHS Providers aims to help trust leaders build on the momentum made during Covid-19 and support NHS boards lead their organisations into the next stage of digitisation. It includes a number of board-level case studies as well as key Covid-19 reflections and lessons from other sectors. It also sets out useful questions for board leaders as they reflect on their own digital leadership.

Workforce race inequalities and inclusion in NHS providers The NHS has one of the most ethnically diverse workforces in the public sector. However, year after year, ethnic minority staff report worse experiences in terms of their lives and careers, when compared with white staff, and people from an ethnic minority background are under-represented in senior positions in the NHS.

Institutional racism in the NHS: what does it look like and how can we address it? You’re not even recognising my talents or my hard work... you’re just lumping me in a category based on the colour of my skin. Despite the NHS having a diverse workforce, staff from ethnic minority backgrounds continue to experience worse levels of bullying and a lack of opportunities for career progression. This report looks at how three NHS providers are working to better support staff and address these inequalities.

The Future Doctor programme: a co-created vision for the future clinical team This report sets out a vision for future clinical teams and how education and training can evolve so that our future doctors are equipped with the right skills to deliver care in an ever-changing health care landscape. It outlines how medical education can be reformed so doctors better understand population needs, develop generalist skills and work effectively in multi-professional teams.

The UK’s points-based immigration system: further details This statement provides further details on the government's plans for a new UK points-based immigration system. It includes information on: the requirements of the points-based system; salary and skills thresholds for skilled workers; a route for students and graduates; who can apply; visiting the UK; and other immigration routes.

Funding for healthcare students in England. A House of Commons briefing paper outlines the funding system for healthcare students, medical and dentistry students and paramedics. It discusses the impact of the 2017 reforms on entrants to healthcare degrees and outlines new funding arrangements for nursing, midwifery, healthcare students and paramedics from September 2020.

Supporting staff to return to the workplace With the recent announcement to pause shielding for clinically vulnerable people from 1 August 2020, there will be greater numbers of staff returning to the workplace. This guidance outlines: the organisational considerations when planning for staff to return; tips for managers; signposts to useful resources; and good practice examples from NHS trusts.

NHS Pay Review Body: thirty-third report 2020 This report sets out analysis of evidence provided by relevant organisations and makes observations on the pay of NHS staff paid under Agenda for Change for 2020 to 2021.

Testing times: an ethical framework and practical recommendations for Covid-19 testing for NHS workers THIS Institute at the University of Cambridge has undertaken a rapid response project to develop an ethical framework for Covid-19 testing for NHS workers. It sought to identify and characterise the ethical considerations likely to be important to the testing programme, while recognising the tension between different values and goals.

News

Childcare costs for doctors to be covered in drive to boost GP numbers 

Beyond the bursary: workforce supply The current nursing workforce shortage is the result of successive governments’ underinvestment in workforce supply. To get more people into the nursing degree and successfully graduating in England, the government must provide appropriate support both on entering and throughout the degree. This report details modelling undertaken by London Economics, which demonstrates the level of funding required to increase the number of applicants to the nursing degree.

Government launches Health and Care Visa to ensure UK health and care services have access to the best global talent The new Health and Care Visa will make it cheaper, quicker and easier for healthcare professionals from around the world to come to the UK.

Health and care workers to self-isolate on return to England from high-risk countries Registered health and care professionals travelling to the England from high-risk countries will be required to self-isolate for 14 days, the government has confirmed.

NHS doctors and dentists to receive 2.8% pay rise NHS dentists and doctors in England will receive a 2.8% pay rise, backdated to April 2020.

Bevan Brittan Updates

Employment Eye: Focus on Higher Education - July 2020 - Ashley Norman

Bevan Brittan Events

UK immigration law: an overview for employers - 10 September 2020

How we can help

We can offer support and advice on managing many workforce issues including furlough leave, managing bank staff, vulnerable groups, sick pay, leave options, supporting staff well-being, presenteeism, remote and home working, lay-offs/short term working through FAQs, helpline or policy guidance and practical day to day advice. 

If you wish to discuss any employment issues generally please contact Jodie Sinclair, Alastair Currie or James Gutteridge.

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Finance 

Publications/Guidance

A Spending Review for wellbeing This briefing paper estimates that the economic and social cost of mental ill health in England has grown in the past decade to almost £119 billion a year.

Coronavirus: Economic impact. The coronavirus outbreak has impacted the UK economy in a number of different ways. The magnitude of the recession caused by the virus is unprecedented in modern times. While a recovery is underway, there is uncertainty over how fast economic activity will regain lost ground. This briefing examines the economic impact of the crisis to date and outlines the key issues for the outlook. It summarises policy measures introduced to mitigate the economic effects of Covid-19 and details the impact on the public finances.

The outlook for the public finances under the long shadow of Covid-19 This report outlines how the Covid-19 outbreak – and the public health response to it – will dramatically reduce economic activity in the second quarter of 2020. This in turn will depress tax receipts and add to government spending, increasing government borrowing and in turn adding to government debt. This report sets out three scenarios for the outlook for growth over the next five years and describes what in turn these might mean for government borrowing and government debt.

Funding for healthcare students in England. A House of Commons briefing paper outlines the funding system for healthcare students, medical and dentistry students and paramedics. It discusses the impact of the 2017 reforms on entrants to healthcare degrees and outlines new funding arrangements for nursing, midwifery, healthcare students and paramedics from September 2020.

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

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Information sharing/data 

Publications/Guidance

Maintaining records of staff, customers and visitors to support NHS Test and Trace Department of Health and Social Care guidance for organisations in certain sectors on collecting details and maintaining records of staff, customers and visitors on their premises to support NHS Test and Trace. Areas covered include: the purpose of maintaining records, the sectors that this guidance applies to, information to collect, how records should be maintained, when information should be shared with NHS test and trace, and how NHS test and trace will take steps to minimise transmission. The Executive Chair of NHS Test and Trace encourages public, businesses and organisations to "play their part in new national effort" by providing names and phone numbers with venues and businesses they visit from 4 July 2020.

ICO launches self-assessment Freedom of Information toolkit.  The Information Commissioner's Office (ICO) has launched an online toolkit to help public authorities respond to freedom of information (FOI) requests as organisations prepare to recover from the coronavirus (COVID-19) pandemic. The toolkit is designed to help public authorities self-assess their performance in responding to FOI requests and generates a bespoke report which helps to identify areas for improvement and where action needs to be taken.

Bevan Brittan Updates

ICO Launches FOI Toolkit for Public Authorities

How we can help

We can provide advice and support in relation to disclosure of information under the both the General Data Protection Regulations and Freedom of Information Act, as well as information sharing, guidance on policy and procedures, and bespoke data protection advice.  We also have expertise advising on the common law duty of confidentiality, the Access to Health Records Act 1990 as well as representing clients in respect of investigations made by the Information Commissioner. 

If you wish to discuss any aspect of information law generally please contact Jane Bennett. 

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Inquests  

Publications/guidance

Excess non-Covid-19 deaths in England and Wales between 29th February and 5th June 2020 This report looks at excess non-Covid-19 deaths in the period between 29 February to 5 June 2020, using historical trends. Its findings include that 9,000 non-Covid-19 deaths in England during three months of the pandemic would not have occurred had the pandemic not happened.

The Coroner Service Inquiry. The Coroners and Justice Act 2009 introduced changes to the Coroner Service including the appointment of the Chief Coroner. These changes were implemented in 2013. The Ministry of Justice reviewed the Act’s effectiveness in 2015, but it has not published the result. The Committee’s inquiry will examine the effectiveness and capacity of the Coroner Service and whether enough progress has been made since the 2009 changes in improving bereaved people’s experience of the Coroner Service. The deadline for written evidence is 2 September 2020

Cases

R (on the application of Antonia Iroko) (Claimant) v (1) HM Senior Coroner for Inner London South (2) HM Assistant Coroner for Inner London South (Defendant) & Lewisham & Greenwich NHS Trust (Interested Party) [2020] EWHC 1753 An inquest that complied with the procedural obligation in ECHR art.2 was not required in the case of a hospital patient who died following a cardiac arrest where, after one round of cardiopulmonary resuscitation, the registrar leading the resuscitation team had taken the clinical decision that further resuscitation attempts would be inappropriate.

Bevan Brittan Updates

Inquests and COVID-19 – amended guidance from the Chief Coroner – PPE and the Workplace - Julia Jones.

If you  wish to discuss any queries you may have around inquests please contact Toby De Mellow.

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Mental Health 

Publications/guidance 

National Child Mortality Database – Report on Child Suicide during the COVID-19 Pandemic in England The National Child Mortality Database (NCMD) responded to the COVID-19 pandemic by accelerating its notification and analysis service to develop a real-time surveillance system. This report describes findings from that system relating to death by suicide. Likely suicides occurring between 1st January – 17th May 2020 were identified from NCMD records.

Coronavirus: impact on young people with mental health needs This second survey with young people by YoungMinds investigating the mental health impact of the Covid-19 coronavirus pandemic shows that many are under increasing pressure and struggling to get the right support. The report reflects the results of a survey with 2,036 young people aged 13-25 with a history of mental health problems, carried out between 6 June and 5 July. It follows on from a similar survey carried out in March, at the start of the lockdown period.

National Child Mortality Database – Report on Child Suicide during the COVID-19 Pandemic in England The National Child Mortality Database (NCMD) responded to the COVID-19 pandemic by accelerating its notification and analysis service to develop a real-time surveillance system. This report describes findings from that system relating to death by suicide. Likely suicides occurring between 1st January – 17th May 2020 were identified from NCMD records.

The Learning Disabilities Mortality Review Programme – Annual Report This is the fourth annual report of the English Learning Disabilities Mortality Review (LeDeR) programme. It presents information about the deaths of people with learning disabilities aged 4 years and over notified to the LeDeR programme from 1st July 2016 – 31st December 2019, with a focus on deaths reviewed during 2019.

Best interests decisions: A COVID-19 quick guide. This quick guide aims to help people across social care and health settings to apply its provisions about making best interests decisions for or on behalf of people who lack the relevant capacity in the context of the COVID-19 pandemic.

The mental health emergency: how has the coronavirus pandemic impacted our mental health? The findings of this survey of more than 16,000 people during lockdown reveals the scale of the impact of the pandemic on people with mental health problems. Two out of three (65 per cent) adults over 25 and three-quarters (75 per cent) of young people aged 13-24 with an existing mental health problem reported worse mental health.

Guidance on vulnerable prisoners during Covid-19 The Parole Board has issued guidance to members on children and prisoners in secure hospitals/mental health units during the parole process.

A Spending Review for wellbeing This briefing paper estimates that the economic and social cost of mental ill health in England has grown in the past decade to almost £119 billion a year.

Covid-19: understanding inequalities in mental health during the pandemic This briefing paper, supported by 13 other national mental health charities, explores the mental health inequalities that are associated with the pandemic in the UK. It finds that the virus and the lockdown are putting greater pressure on groups and communities whose mental health was already poorer and more precarious.

Breathing Space: an evaluation of Orbit’s mental health programme Orbit, an affordable homes provider, commissioned HACT to evaluate its Breathing Space programme. The programme is a mental health service established to support Orbit clients in achieving positive improvements in their mental health.

Cases

Cumbria County Council v A [2020] EWCOP 38 ​​Where a deputy wishes to discontinue in the role, an application must be made to the court.

A NHS Foundation Trust v MC [2020] EWCOP 33.​ An NHS Trust was seeking the court's consent for the harvesting of peripheral blood stem cells from the P so that they could be donated to her mother who had chronic leukaemia. The court granted the request.

AA Local Authority v RS (Capacity) [2020] EWCOP 29. The court had to decide whether the P had capacity to decide where he resides, the care he receives, to have contact with others and access to the internet and social media. The court concluded that he did have capacity to make those decisions.

(1) Avon & Wiltshire Mental Health Partnership(2) North Bristol NHS Trust (Applicants) v (1) WA (2) DT (Respondents) & Official Solicitor (Advocate to the Court) [2020] EWCOP 37 A patient who was refusing nutrition and hydration lacked mental capacity to conduct proceedings within the meaning of the Mental Capacity Act 2005 s.3(1)(c) where his traumatic past had affected him to the point that he had become fixated on the fact that the Home Office had re-assigned his date of birth, which he perceived as an assault on his identity. That fixation occluded his ability to weigh the relevant information in the context of a global decision, constituting an impairment of the mind. 

Tower Hamlets London Borough Council v PB (By his litigation friend, The Official Solicitor) [2020] EWCOP 34 The Court of Protection assessed the capacity of a patient who was dependent on alcohol and concluded that his desire to continue to drink, while unwise, did not mean that he lacked capacity to decide where he lived and what type of care he received. The court re-stated the principles to be applied to assessments of capacity and emphasised that the desire to protect vulnerable people from poor decisions should not eclipse their autonomy.

News

Liberty Protection Safeguards delayed until April 2022 The Minister for Care, Helen Whately, has made a written statement to Parliament confirming that the new regime of Liberty Protection Safeguards, replacing DoLS, will now not come into force this October and implementation has been put back to April 2022. Before then, a 12 week public consultation will be launched on the draft regulations and the new Code of Practice.

£62 million to help discharge people with learning disabilities or autism into the community People with learning disabilities or autism who could be better supported in their community will have their discharges from hospital accelerated.

New online service to improve Lasting Power of Attorney. The Office of the Public Guardian has launched an new digital lasting power of attorney tool to help those acting as an attorney to contact organisations like banks and healthcare providers more easily. It replaces a paper-based system which can delay decisions, whilst maintaining safeguards to protect from abuse.

The new NHS and mental health: where are we going wrong? Jihad Malasi, Mental Health Commissioner of Thanet Clinical Commissioning Group, shares his experience providing mental health care in his 17 years as a doctor and considers how primary care networks could be the answer to holistic mental health primary care.

Bevan Brittan Updates

Case summary: Avon and Wiltshire Mental Health Partnership v WA & Anor [2020] EWCOP 37 - Melanie Lothbrok

Case Summary: Hull University Teaching Hospitals NHS Trust v KD [2020] EWCOP 35 - Toby de Mellow

Case Summary: Tower Hamlets London Borough Council v PB [2020] EWCOP 34 - Hannah Taylor

Case Summary: A Local Authority v JB [2020] (Court of Appeal) - Lauren Howe

Bevan Brittan Education Lunches 

These are internal hour long lunch time training sessions that are attended by our team of solicitors. If your organisation is a Bevan Brittan client you can sign up to watch the training sessions remotely via our webinar facility. Please contact Claire Bentley if you would like to attend any of our webinars remotely/would like to receive our education lunch programme for 2020. 

Proposed changes to the Mental Health Act; a few observations. 13 August 09.30 - 10.15. Join us for the first in a series of important updates to the proposed changes of the new Mental Health Act. In this first webinar hosted by Simon Lindsay and Jennifer Nwachukwu we will be reviewing some of the key themes of the Wessely Report and the ideas and themes underlying its proposals. In particular, this session will look at how far recent human rights law developments are reflected in the discussion and recommendations the report makes.

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 Dr will Zoom you now: getting the most out of the virtual health and care experience Remote consultations and the use of technology offer some great opportunities to make significant improvements to general practice, hospital outpatient and mental health appointments, but making the most of this opportunity means understanding the patient experience. This report was a rapid, qualitative research study designed to understand the patient experience of remote and virtual consultations. The project was led in partnership with Traverse and Healthwatch England.

RCGP survey provides snapshot of how GP care is accessed. Remote consultations can provide both benefits and challenges for patients and GPs and while convenient and efficient for many, ‘won’t be suitable or preferable for everyone’ the Royal College of GPs has said as it releases the results of a survey of its members.

General Practice in a Post-COVID World outlines how GPs will be on the frontline of dealing with the physical and psychological health consequences of the COVID-19 virus, and the need for urgent government planning and funding to prepare general practice services for facilitating the recovery of local communities.

Rebuilding the NHS: resetting outpatient services for the 21st century in the context of Covid-19 In this document the RCP, together with the Royal College of General Practitioners, set out principles and recommendations for the reset of outpatient services. The Covid-19 pandemic has demonstrated that the NHS can adapt quickly and presents an opportunity to reset outpatient services.

New animations showcase a career in general practice A series of imaginative short animations covering the application process, flexible options and life as a GP have been developed by Health Education England (HEE) ahead of its latest GP training application round which kicks off this week.

GP Patient Survey: national report 2020 The GP Patient Survey (GPPS) is an England-wide survey, providing GP practice level data about patients’ experiences of general practice. Ipsos MORI administers the survey on behalf of NHS England. This report sets out the national headline and summary findings for the 2020 GPPS publication. For 2020 some additional analysis has been completed that looks at the impact of Covid-19 on the survey results.

Primary care networks: one year on This report assesses the progress of primary care networks (PCNs), a year after they were established. It finds that, while the picture nationally is one of variation, progress has been made in several areas. Many PCNs have significantly expanded their use of digital platforms, allowing more patients to be seen during Covid-19, and built strong new relationships with other partners across primary care.

New system alerts GPs to Covid-19 test results UK Authority, 20 July 2020 NHS Digital has developed a new service that alerts patients and GPs of Covid-19 results and enters the results into GP records.

Mental health and primary care networks: understanding the opportunities. The establishment of primary care networks (PCNs) is one of the most important reforms to primary care in England in recent years. This report, published jointly by The King’s Fund and the Centre for Mental Health, explores the opportunities the emergence of these new networks creates for improving the support and treatment provided to people with mental health needs in primary care, and describes why such improvement is badly needed.

How to enhance the integration of primary care and public health? Approaches, facilitating factors and policy options This policy brief explores how primary care and public health can be brought together to improve the health of patients and populations. It describes the types of initiatives that have been undertaken; provides examples of such initiatives in Europe and beyond; and summarises the factors that can help to enhance or hinder the integration of primary care and public health.  

The Future Doctor programme: a co-created vision for the future clinical team This report sets out a vision for future clinical teams and how education and training can evolve so that our future doctors are equipped with the right skills to deliver care in an ever-changing health care landscape. It outlines how medical education can be reformed so doctors better understand population needs, develop generalist skills and work effectively in multi-professional teams.  

New recommendations for primary and community health care providers in England. This guidance will be reviewed as new detail and evidence on COVID-19 emerges. As rates of COVID-19 change in both community and healthcare settings, and notably the nosocomial transmission of SARS-CoV-2 decreases, the case for continued use of the extended face mask recommendations will be reviewed.

News

The new NHS and mental health: where are we going wrong? Jihad Malasi, Mental Health Commissioner of Thanet Clinical Commissioning Group, shares his experience providing mental health care in his 17 years as a doctor and considers how primary care networks could be the answer to holistic mental health primary care.

Primary care leaders call for greater freedom to improve the health of their local communities. GPs, pharmacists and nurses who are responsible for leading networks of general practices in England want greater flexibility and autonomy to work in a way that is more responsive to their local populations.

Childcare costs for doctors to be covered in drive to boost GP numbers.

Bevan Brittan Updates

Bevan Brittan has collaborated with NHS Resolution to produce a series of videos outlining key areas in general practice that frequently give rise to claims. Members of our clinical negligence team draw on their wealth of experience in dealing with claims to highlight the common areas of risk, provide guidance on how to mitigate or avoid these issues, and what steps to take if a complaint or a claim is received. The first three videos in this series are available to watch now. See below:-
Consent - Daniel Morris
Medical record keeping - Ben Lambert
Administrative errors - Susan Trigg

Other useful resources from NHS Resolution for primary care are set out below:-
1. General Practice Indemnity schemes
2. Understanding the Clinical Negligence Scheme for General Practice
3. Handling claims under the Clinical Negligence Scheme for General Practice
4. Covid-19 guidance for general practice 

Bevan Brittan Events

WEBINAR - Proposed changes to the Mental Health Act; a few observations. Thursday 13 August; 09.30 - 10.15. Join us for the first in a series of important updates to the proposed changes of the new Mental Health Act. In this first webinar hosted by Simon Lindsay and Jennifer Nwachukwu we will be reviewing some of the key themes of the Wessely Report and the ideas and themes underlying its proposals. In particular, this session will look at how far recent human rights law developments are reflected in the discussion and recommendations the report makes. If you would like to attend this webinar, please email Claire Bentley and ask for the link.

How we can help   

We can offer support and advice on managing contractual and operational issues affecting the delivery of primary care services, including emerging legislative changes, updated guidance and policy arrangements, workforce issues and any transactional – related matters relating to vertical integrations, STPs, PCNs, etc. If you wish to discuss any commercial, corporate or regulatory issues in primary care then please contact Vincent Buscemi.

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Providers 

Publications/Guidance  

A new era of digital leadership. This guide published by NHS Providers aims to help trust leaders build on the momentum made during Covid-19 and support NHS boards lead their organisations into the next stage of digitisation. It includes a number of board-level case studies as well as key Covid-19 reflections and lessons from other sectors. It also sets out useful questions for board leaders as they reflect on their own digital leadership.

The NHS after Covid-19: the views of provider trust chief executives This report is based on interviews with 13 provider trust chief executives in which they discuss the changes they have made to respond to Covid-19, as well as how best to restart and deliver services as we move into the next phase of the pandemic. The interviews took place in late May and early June 2020. The cohort identified three key concerns in resetting services following the emergency response to the pandemic: staff wellbeing, restarting other NHS services safely, and the long-term impact on health inequalities.

COVID-19: guidance for commissioners and providers of services for people who use drugs or alcohol COVID-19 guidance for commissioners and service providers for those dependent on drugs or alcohol.

Workforce race inequalities and inclusion in NHS providers The NHS has one of the most ethnically diverse workforces in the public sector. However, year after year, ethnic minority staff report worse experiences in terms of their lives and careers, when compared with white staff, and people from an ethnic minority background are under-represented in senior positions in the NHS.

PPE portal: how to order emergency personal protective equipment Healthcare providers can order additional personal protective equipment (PPE) through the portal to top up their existing supplies for COVID-19 in an emergency.

The impact of technology in adult social care provider services Digital Social Care (a group of organisations working to support adult social care providers) set up a helpline to provide technical help and support to providers adapting to digital platforms as Covid-19 took hold. They worked with IPC to carry out research with social care providers to help them tackle digital challenges during the pandemic and beyond. This report of the action research identifies both the challenges but also the benefits for care providers of using technology.

Institutional racism in the NHS: what does it look like and how can we address it? You’re not even recognising my talents or my hard work... you’re just lumping me in a category based on the colour of my skin. Despite the NHS having a diverse workforce, staff from ethnic minority backgrounds continue to experience worse levels of bullying and a lack of opportunities for career progression. This report looks at how three NHS providers are working to better support staff and address these inequalities.

New recommendations for primary and community health care providers in England. This guidance will be reviewed as new detail and evidence on COVID-19 emerges. As rates of COVID-19 change in both community and healthcare settings, and notably the nosocomial transmission of SARS-CoV-2 decreases, the case for continued use of the extended face mask recommendations will be reviewed.

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

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Public Health 

Publications/guidance

Tackling obesity: empowering adults and children to live healthier lives It has been known for decades that living with obesity reduces life expectancy and increases the chance of serious diseases such as cancer, heart disease and type 2 diabetes. In the past few months it has been seen that excess weight puts individuals at risk of worse outcomes from coronavirus (Covid-19). This policy paper outlines actions the government will take to tackle obesity and help adults and children to live healthier lives.

Excess weight and Covid-19: insights from new evidence This report brings together findings from UK and international studies published during the coronavirus (Covid-19) pandemic. It offers information about excess weight and its association with Covid-19 for the following outcomes: laboratory confirmation; hospitalisation; admission to intensive or critical care and treatment; and risk of mortality. The report offers some important insights into the prevalence, causes and risks of being overweight and also includes information regarding food and drink purchases and physical activity during the lockdown. It is intended to provide insights for policy-makers and those in health marketing.

The Future Doctor programme: a co-created vision for the future clinical team This report sets out a vision for future clinical teams and how education and training can evolve so that our future doctors are equipped with the right skills to deliver care in an ever-changing health care landscape. It outlines how medical education can be reformed so doctors better understand population needs, develop generalist skills and work effectively in multi-professional teams.  

Coronavirus (Covid-19): the impact on prisons. Covid-19 presents an unprecedented public health crisis that has put additional pressure on a prison system already in a state of crisis. This report looks at the measures the Ministry of Justice and HM Prison and Probation Service have taken in response, focusing primarily on regime changes and strategies to manage the prison population.

Ageing prison population The number of prisoners over the age of 60 has risen between 2002 and 2020 from 1,511 to 5,176 – an increase of more than 240 per cent. A large proportion of older prisoners have distinct health and social care needs. Prisoners tend to have worse health than the wider community – 85 per cent of prisoners over the age of 60 have some form of major illness. The Justice Committee reaffirms the call of a previous Justice Committee for the government to produce a national strategy for older prisoners.

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

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Regulation  

Publications/Guidance 

2019 adult inpatient survey statistical release. The majority of people who stayed as an inpatient in hospital were happy with the care they received, had confidence in the doctors and nurses treating them and felt their fundamental needs were met, according to the latest CQC adult inpatient survey. However, survey respondents were less positive about arrangements and information received when leaving hospital, and access to support and further services once at home. This was a particular concern for people who self-reported as being frail. The survey was conducted before the Covid-19 pandemic.  

Cases

R (on the application of Ashish Dutta) v GMC [2020] EWHC 1974 (Admin) QBD  The High Court examined the guidance and case law on assessing witness credibility. It criticised the reasoning given by the Medical Practitioners Tribunal when making findings of fact against a cosmetic surgeon and suspending him on the ground that his fitness to practise was impaired. The court also considered the "five-year" test in the General Medical Council (Fitness to Practise) Rules Order of Council 2004 Sch.1 r.4(5) and gave guidance how to interpret and apply the term "allegation".        

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

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Social Care  

Publications/Guidance 

The impact of technology in adult social care provider services Digital Social Care (a group of organisations working to support adult social care providers) set up a helpline to provide technical help and support to providers adapting to digital platforms as Covid-19 took hold. They worked with IPC to carry out research with social care providers to help them tackle digital challenges during the pandemic and beyond. This report of the action research identifies both the challenges but also the benefits for care providers of using technology.

Readying the NHS and social care for the Covid-19 peak This report finds that the government’s 'slow, inconsistent, and at times negligent approach' to social care in the Covid-19 pandemic has exposed the 'tragic impact' of 'years of inattention, funding cuts and delayed reforms', leaving the sector as a 'poor relation' that has suffered badly in the pandemic

Coronavirus (COVID-19): admission and care of people in care homes How to protect care home residents and staff during the coronavirus outbreak.

Visiting care homes during coronavirus Guidance for making arrangements for limited visits for care homes with the support of their director of public health.

Technology checklist for video calling an adult or carer This checklist covers the necessary steps a social worker or practitioner should take to ensure that technology for video calling is ready and appropriate.

Coronavirus (COVID-19): guidance for people receiving direct payments Advice for people who buy care and support through a direct payment, as well as local authorities, clinical commissioning groups and those who provide care and support. Change made Added easy read document ‘Using direct payments during the coronavirus outbreak: guidance for people receiving direct payments and personal assistants’.

News

NHS Digital to collect social care data for Covid-19 research UK Authority, 16 July 2020 NHS Digital has announced that the Social Care Data Collection for Pandemic Planning and Research will take responsibility for collecting anonymous social care data to support Covid-19 research.

Bevan Brittan Updates

New Guidance - Visiting arrangements in care homes - Sarah Clarke

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

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General 

Publications/Guidance  

We are the NHS: People Plan for 2020/21 – action for us all. This plan sets out what the people of the NHS can expect – from their leaders and from each other – for the rest of 2020 and into 2021. It sets out actions to support transformation across the whole NHS. It focuses on how we must all continue to look after each other and foster a culture of inclusion and belonging, as well as action to grow our workforce, train our people, and work together differently to deliver patient care.The Health Secretary has welcomed the launch of the new NHS People Plan as part of a "bureaucracy-busting" drive so staff can spend less time on paperwork and more time with patients. The NHS People Plan puts NHS staff wellbeing at its heart with a new recruitment, retention and support package. It sets out practical support for wellbeing such as safe spaces to rest and recuperate, wellbeing guardians and support to keep staff physically safe and healthy.

UK Biobank COVID-19 seroprevalence study: round 1 results. First round of results of a 6-month study of coronavirus (COVID-19) antibody levels over time.

Multi-agency statutory guidance on female genital mutilation Multi-agency guidelines on FGM for those with statutory duties to safeguard children and vulnerable adults.

Covid-19 rapid guideline: arranging planned care in hospitals and diagnostic services The purpose of this guideline is to help health care professionals deliver efficient planned care while minimising the risk of Covid-19 in the context of increasing or decreasing local prevalence. It also aims to help patients make decisions about their planned care. It is for adults, young people and children in hospitals and diagnostic settings. Planned care covers elective surgery (day surgery and inpatient stays), interventional procedures, diagnostics and imaging. It does not include services where people have ongoing outpatient and day-case procedures, such as chemotherapy, radiotherapy and dialysis.

Coronavirus Act report: July 2020 The second two-monthly report on which powers in the Coronavirus Act 2020 are currently active.

Coronavirus: health and social care key issues and sources This briefing brings together and summarises some of the key issues that MPs have raised on behalf of their constituents around the impact of coronavirus (Covid-19) on the health and care sectors.

Returning the NHS to an even keel. This briefing provides insight into the challenges facing medical specialties. It shows that almost half of physician specialties, including cardiology, gastroenterology and rheumatology, expect to be working at less than previous pre-Covid activity levels for at least 12 months or more. The briefing captures several aspects of restarting activity, including specialty capacity, adaptations to services and co-dependencies. It also provides an insight into potential capacity scenarios in genitourinary medicine and rheumatology.

Preparing for a challenging winter 2020/21 This report states that the UK must prepare now for a potential new wave of coronavirus infections this winter that could be more serious than the first. It stresses that ‘intense preparation’ is urgently needed throughout the rest of July and August to reduce the risk of the health service being overwhelmed and to save lives this winter. The accompanying People's perspective report calls for these actions to be developed through engagement with patients, carers and the public to ensure services, guidelines and communications work for people, rather than focusing plans on individual medical conditions.

NHS capital expenditure and financial management: Eighth Report of Session 2019-21. A Public Accounts Committee report on NHS capital expenditure and financial management warns that Government does not have either a clear understanding of the equipment needed for clinical and care workers, or how to distribute it - particularly in the more fragmented care sector. It calls for a detailed plan for personal protective equipment (PPE) within two months, ahead of a potential second wave of coronavirus (COVID-19).

The hidden impact of Covid-19 on patient care in the NHS in England The Covid-19 pandemic led to an extensive shift in the package of care provided by the NHS as hospitals had to prepare for a large surge in patients requiring intensive care. While these changes meant that intensive care did not have to be rationed to Covid-19 patients, data indicates that the shutdown of most non-Covid services, combined with drastic changes in patient behaviour, mean the NHS is now facing a large backlog of non-Covid-19 care, storing up greater problems for the future. This paper investigates the extent to which non-Covid care has been disrupted over April, May and June 2020, and the likely impact this will have in the longer term.

Capturing beneficial change from the Covid-19 pandemic This report is a response to a request from NHS England and NHS Improvement for examples of beneficial innovations across the NHS that have been implemented during the Covid-19 pandemic and should be retained as the NHS starts to resume business as usual. British Geriatrics Society members contributed examples of innovations that have been implemented in their areas.

Resuming health services during the Covid-19 pandemic: what can the NHS learn from other countries? This briefing looks at the approaches other countries around the world have taken in dealing with the pandemic. It considers what might be learnt from the approaches used internationally, and how long it might take to fully recover.

National Institute for Health and Care Excellence annual report and accounts 2019 to 2020. A National Institute for Health and Care Excellence (NICE) annual report and accounts for 2019 to 2020 contains information on performance, accountability, and audit, as well as financial statements for 2019 to 2020.

NICE publishes new COVID-19 rapid guideline on arranging planned care NICE has published a guideline on the arrangements the NHS should put in place for patients needing elective surgery and other planned treatments and procedures (including diagnostics and imaging) during the COVID-19 pandemic.

Rebuilding the NHS: resetting outpatient services for the 21st century in the context of Covid-19 In this document the RCP, together with the Royal College of General Practitioners, set out principles and recommendations for the reset of outpatient services. The Covid-19 pandemic has demonstrated that the NHS can adapt quickly and presents an opportunity to reset outpatient services.

News 

Court rejects bid to stop destitute migrants being charged for NHS maternity care. A bid to stop destitute migrant women being charged for NHS maternity care has been rejected by the High Court. Maternity Action, which launched a legal challenge, has criticised the Government's decision not to overhaul the "punitive charging regime". Rules specify overseas women from outside the EU who are expecting a baby must be charged for NHS care, with debt from maternity care affecting future immigration applications.

If you wish to discuss any queries around this general topic please contact Claire Bentley.

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