20/09/2022

Bevan Brittan provides high quality, comprehensive advice to the NHS, independent healthcare sector and local authorities. 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, independent sector and local authorities which have been published in the last month. 

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Training Events 

Information Sharing/Data

Acute and emergency care

Inquests

Children/young people

Mental Health

Clinical Risk/Patient Safety

Primary Care

Digital Health

Regulation

Employment/HR

Social Care

Finance

General

Health Inequalities

 

 

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Bevan Brittan Free Training Events 

Bevan Brittan Clinical Risk/Health, Care and Regulatory Law Team Training - These are internal hour long lunch time training sessions.  You can sign up to watch the training sessions remotely via our webinar facility. Please contact Claire Bentley

Recent developments to the MHA 1983 and MCA 2005 - 20th September

Tricky issues involving police in hospitals .- 27th September

Recent developments and causation in inquests - 11th October

An overview of the key changes set out in the Health and Care Act 2022 - 26th October

Please note that registration for each webinar will close when the webinar starts, so please do ensure you have booked your place in advance to guarantee attendance.  

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Acute and emergency care

Publications/guidance

Payment reform, purchaser and provider decisions and the performance of emergency healthcare systems: the case of blended payment in the English NHS This paper constitutes the first and foundational output of the ESHCRU2 project 3 - Analysis of purchaser-provider contracts: modelling risk sharing and incentive implications. This project focuses on the implications of payment reform of what is called blended payment for emergency care. The paper sets out the theoretical model developed to understand how behavioural choices could be influenced by this payment reform.

Initial assessment in emergency departments This guidance makes recommendations for models of initial assessment of patients arriving at emergency departments and provides standard definitions of the processes that classify as initial assessment: streaming, triage, and rapid assessment and treatment.

Next steps in increasing capacity and operational resilience in urgent and emergency care ahead of winter. In a letter to Integrated Care Board Chief Executives and Chairs, and NHS Foundation Trust and NHS Trust Chief Executives and Chairs, NHS England sets out its next steps for increasing capacity and operational resilience in urgent and emergency care ahead of winter 2022-23. It outlines core objectives and key actions relating to: preparing for variants of coronavirus (COVID-19) and respiratory challenges; increasing capacity outside acute trusts; increasing resilience in NHS 111 and 999 services; targeting Category 2 response times and ambulance handover delays; reducing crowding in A&E departments; reducing hospital occupancy; ensuring timely discharge; and providing better support for people at home.

NHS England’s list of trusts with worst elective and cancer problems. Almost a third of acute trusts have been identified by NHS England as being ‘at risk’ of missing key targets for electives and cancer recovery, with some facing “periodic calls between ministers and CEOs.”

News

NHS slashes longest waits for care despite record numbers of most serious 999 calls.

Internal memo warns of ‘increasingly common’ deaths in A&E.

New NHS England figures revealed that 29,317 patients waited 12 hours in accident and emergency from decision to admit to admission in July. This is a significant increase on the 22,034 trolley waits recorded in June and the previous record of 24,138 recorded in April.

NHS rolls out new electric vehicles to help patients and the planet. Eight ambulance trusts are trialling 21 zero-emission vehicles of various types, helping to relieve pressure on ambulance services across the country while also helping the NHS cut its carbon footprint.

Bevan Brittan Events

Tricky issues involving police in hospitals. Elliot Gold of Serjeants’ Inn Chambers will consider the scope and limits of police obligations in hospitals.  27th September at 12.30pm.

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 

Women’s Health Strategy for England Details the government’s 10-year ambitions and the actions we are taking now to improve the health and wellbeing of women and girls in England.

School nursing: looking after the health and wellbeing of school children This publication summarises school nurses' important role in the education system and includes case studies from across the country focused on how they provide an invaluable role to children.

Safeguarding children, young people and adults at risk This updated guidance sets out the safeguarding roles and responsibilities of all individuals working in NHS-funded care settings and NHS commissioning organisations.

Urgent action needed on staff shortages as children face missing out on life changing treatments NHS leaders are raising the alarm over chronic staff shortages in critical community health services, that leave patients facing longer waits and at risk of missing out on life changing treatments. The situation has become critical with growing vacancies for district nurses, health visitors, podiatrists, community dentists and speech and language therapists. NHS leaders are now warning that unless urgent action is taken, the size of the waiting list for community services – which already stands at more than a million people, including hundreds of thousands of children – will continue to rise. Delays to accessing services such as speech and language therapy – or assessments for autism - can have profound impacts on the lives of children.

Dismissed for too long: the impact of migraine on children and young people An estimated one in ten children are living with migraine. Based on a variety of workshops and surveys with children and young people who have migraine, parents and carers, and education professionals, this report highlights a clear need for better understanding of how migraine impacts children and for tailored information, guidance and support for children and young people of different ages who have migraine.

News

Tavistock gender identity clinic for children to close, with two new services planned. The NHS is closing its gender identity clinic for children at the Tavistock and Portman NHS foundation trust after it was criticised in an independent review by Dr Hilary Cass. In a statement, NHS England said it intended to build a "more resilient service" by expanding provision, and would establish two services led by specialist children's hospitals in London and north-west England. It followed recommendations from Dr Cass who said there was a need to move away from a model of a sole provider, and instead establish regional services to better meet patients' needs.

If you wish to discuss any queries you may have around children please contact Deborah Jeremiah or Ruth Shedlow

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Clinical Risk / Patient Safety

Publications/Guidance 

Patient Safety Incident Response Framework The Patient Safety Incident Response Framework (PSIRF) sets out the NHS’s approach to developing and maintaining effective systems and processes for responding to patient safety incidents for the purpose of learning and improving patient safety.

Safety culture in the NHS This indicator uses data from the NHS Staff Survey to look at safety culture in the NHS.

New claims baseline to support future improvements in general practice care. Analysis of the data from the first year of an indemnity scheme for general practice has identified that quicker and more accurate diagnosis, and improved prescribing processes could result in better patient outcomes, a report from NHS Resolution published today has found. The report provides a comprehensive review of the first year of the Clinical Negligence Scheme for General Practice (CNSGP). CNSGP is the indemnity scheme managed by NHS Resolution, which covers the NHS work of general practice in England for incidents occurring after 1 April 2019.

The distribution of doctor quality: evidence from cardiologists in England There is widespread and unexplained variation in the outcomes of similar patients across place and providers in all developed health systems. This paper provides new evidence on the role senior doctors play in determining patient outcomes. It exploits within-hospital quasi-random assignment of patients to senior doctors following a heart attack to estimate the effectiveness of individual doctors, and to estimate returns to experience for these doctors.

Infected Blood Inquiry. Interim report This report recommends that an interim payment of no less than £100,000 should be paid, without delay, to all those infected and all bereaved partners currently registered on UK infected blood support schemes, and those who register between now and the inception of any future scheme.

Safer care for all: Solutions from professional regulation and beyond. A Professional Standards Authority report highlights challenges affecting the quality and safety of health and social care across the UK and puts forward recommendations to ensure safer care for all. It recommends the appointment of an independent Health and Social Care Safety Commissioner (or equivalent) for each UK country, and addresses tackling inequalities; regulating for new risks; facing up to the workforce crisis; and accountability, fear and public safety.

News

Multiple reporting systems undermine patient safety, says watchdog.  

Folic acid added to flour to prevent brain and spinal conditions in foetuses Folic acid to be added to non-wholemeal flour across the UK to help prevent life-threatening brain and spinal conditions in foetuses.

Bevan Brittan Updates

Fundamental Dishonesty – recent cases

The quest for supermodel looks: advice for aesthetic and cosmetic practitioners

The Patient Safety Incident Response Framework has Launched

Covid Inquiry Opening Statement: modules and Core Participant status

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 Joanne Easterbrook  or Tim Hodgetts.

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Digital Health

Publications/guidance

Updated evidence standards framework NICE has updated their evidence standards framework for digital health technologies to include new evidence requirements for artificial intelligence and data-driven products.

Framework agreement between the Department of Health and Social Care and NHS Digital How the Department of Health and Social Care and NHS Digital agree to work together until NHS Digital merges with NHS England.

Bringing hospital care home: virtual wards and hospital at home for older people This report explores the potential benefits, limitations, and current scientific evidence to be considered when providing a safe, effective, and person-centred alternative to hospital inpatient care for older adults. This publication highlights how ‘virtual wards’ are being funded and implemented. It explains the various definitions of the term ‘virtual wards’ as used in different parts of the UK and describes the face-to-face care delivered by a multidisciplinary team, combined with some remote monitoring.

The need to share digital health lessons across the UK Achieving digital transformation in health and social care in England has long been a goal, yet progress over the past decade has not been straightforward. But what is happening elsewhere in the UK? With Scotland, Wales, Northern Ireland and England all embarking on ambitious digital health programmes, a new explainer from Rachel Hutchings and Jessica Morris describes the various approaches being taken.

Digital technologies and interoperability: enabling the future of integrated care.

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

Additional bank holiday

NHS Pension Scheme: proposed uplifts to the member contribution tier thresholds - consultation response. Following a consultation proposing uplifts to the contribution tier thresholds in line with the Agenda for Change pay award for England announced in July 2022, the Department of Health and Social Care will lay regulations to uplift the contribution tier thresholds in order for the proposed changes to be in place for 1 October 2022.

The NMC’s position on industrial action. The Nursing and Midwifery Council (NMC) has shared an updated statement on industrial action for nurses, midwives and nursing associates. As the nursing and midwifery regulator, the NMC has updated its existing statement on industrial action. The statement covers how industrial action, including strike action, relates to the NMC Code of conduct for nurses, midwives and nursing associates.

Pensions annual allowance compensation charge and scheme This paper for commissioners and practices describes the 2019/20 pensions annual allowance compensation charge policy and scheme which some clinicians, including those working in primary care, can benefit from when they retire.

Code of practice for the international recruitment of health and social care personnel. Sets out the principles and best practice benchmarks health and social care employers and recruitment agencies must follow to ensure effective, ethical international recruitment.

Memorandum of understanding between the Government of Nepal and the Government of the United Kingdom of Great Britain and Northern Ireland on the recruitment of healthcare professionals. A Department of Health and Social Care memorandum of understanding (MoU) sets out the framework under which healthcare workers from Nepal will be recruited to the UK. The MoU includes: general principles of recruitment; implementation; and the establishment of a joint committee to oversee implementation of the provisions of the MoU. The MoU is signed on the basis that the active recruitment of health care workers from Nepal to the UK will begin with an initial pilot phase lasting approximately 15 months. Following the pilot, further government-to-government discussions will be held on widening recruitment to other UK employers, agencies and to include other types of health workers.

There is no community without people: The staffing challenges facing community health services and how we can address them The community healthcare sector is suffering a staffing crisis, which is having a profound impact on service users and the wider NHS.

Overseas hiring spree planned for care homes in England amid winter fears.Foreign workers could be recruited for care homes in England under government plans amid concerns about staff shortages this winter. The health secretary, Steve Barclay, wants the overseas recruitment spree to include sending NHS managers to countries such as India and the Philippines to hire thousands of nurses

Covid death payments unavailable for staff who died in most recent waves. The families of any NHS and social care staff who died from covid in the most recent waves will not be eligible for the covid death assurance scheme launched at the start of the pandemic, it has emerged. The scheme closed on 31 March, despite pleas from the Royal College of Nursing to keep it open. Since it was set up in April 2020, it has paid out £60,000 lump sums to the estates of 688 workers. A further 42 cases have been declined and 29 applications are still being processed. The scheme has been notified of six deaths which occurred in the first three months of 2022 and families have until 31 March 2023 to make claims for any relatives who died before the 31 March 2022 cut off date.

Menopause and the workplace This report explores menopause as a health issue, a workplace issue and, fundamentally, as an equality issue, in relation to which people need better legal protection. It seeks to raise awareness across wider society, drive change among employers, and encourage a proactive and collaborative approach by the government.

Enhancing Junior Doctors’ Working Lives: annual progress report 2022 This is the sixth report that looks at the achievements over the past year of the Enhancing Junior Doctors’ Working Lives programme in providing improved support for doctors in training. The programme was established in March 2016, to address a range of issues that were having a significant negative impact on the quality of life of doctors in postgraduate training. Led by Health Education England (HEE), it is a cross-system collaboration to drive and deliver system improvements and meaningful change to postgraduate medical training. HEE worked collaboratively with system partners in the Academy of Medical Royal Colleges, the GMC, NHS Employers and the BMA as well as individual Medical Royal Colleges and the devolved nations to address those issues and provide trainees and stakeholders with yearly updates on progress.

Adult social care workforce in England This research briefing gives an overview of key issues and policy concerning the adult social care workforce in England. Around 1.5 million people worked in the adult social care sector in England in 2021/22, more than in the NHS. The workforce was more diverse than the population as a whole and the majority of workers were women. Around a quarter of the workforce were on zero-hours contracts, including 55 per cent of home care workers.

Code of practice for the international recruitment of health and social care personnel in England. A Department of Health and Social Care code of practice for health and social care organisations in England on international recruitment of personnel, updated to: strengthen best practice benchmarks including the setting of principles on the use of repayment clauses in employment contracts; set out the routes of escalation for concerns about exploitative recruitment or employment practices and breaches of the code; clarify how the code applies to different international recruitment models; and expand scenario examples on how the code applies in practice. The Scottish Government has also published a revised "Scottish Code of Practice for the international recruitment of health and social care personnel".

News

Odds stacked against it: how social care struggles to compete with supermarkets on pay. Pay is a key reason for the social care workforce crisis, says Simon Bottery (Senior Fellow in Social Care at The King's Fund). Nearly 400,000 care workers would be financially better off working in supermarkets.

How we can help

We can offer support and advice on managing many workforce issues including flexing your workforce to respond to the pandemic, managing bank staff, redeployment, vulnerable groups, sick pay, leave options, supporting staff well-being, presenteeism, remote and home 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

NHS-funded nursing care practice guidance. Guidance on the principles and processes of NHS-funded nursing care.

For more information contact Claire Bentley.

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Health Inequalities 

Publications/Guidance

Fuel poverty, cold homes and health inequalities This report reviews the evidence on both the direct and indirect impacts of fuel poverty and cold homes on health; the inequalities in who this affects the most; and the relationship between health inequalities and climate change.

Life changing care: the role, gaps and solutions in providing social care to people experiencing homelessness This report examines the provision of care services for people who have been homeless and finds they are missing out on the care they need and deserve because of a lack of specialist provision. People who have experienced homelessness often have multiple and complex health conditions, which can result in their care needs being much higher and more prevalent at an earlier age than the general population. The report makes eight recommendations about how to improve the current situation.

The continuing impact of Covid-19 on health and inequalities This long read revisits the conclusions of The Health Foundation's Covid-19 impact inquiry, published in July 2021, to consider the further direct impact of Covid-19 on health outcomes and the broader implications for health and the wider determinants. It also discusses the extent to which previously highlighted risks to health have been addressed and the implications for the country of ‘living with Covid-19’.

The impact of the pandemic on population health and health inequalities. This report looks at the impact of the pandemic on population health and health inequalities in the UK. It discusses how the pandemic has affected the nation’s physical and mental health, as well as social determinants of health such as education and employment. The report aims to pay particular attention to inequalities and how these pandemic effects were distributed. It also looks at the positive lessons that can be learnt from the vaccine rollout and efforts to tackle homelessness.

Inequality on the inside: Using hospital data to understand the key health care issues for women in prison Is good-quality health care being provided for women in prison? As the government proceeds with plans to build 500 more prison places for women, this new Nuffield Trust analysis uses HES data to look at women prisoners' use of hospital services, finding that they face a series of challenges and risks in prison because of barriers to accessing health and care services.

Quantifying health inequalities in England This analysis uses linked hospital and primary care data to examine socioeconomic, regional and ethnic variations in the prevalence of diagnosed long-term illnesses. The analysis also uses the Cambridge Multimorbidity Score to assess the relative impact of different patterns of illness on people and their health care needs. It finds a 60-year-old woman in the poorest areas of England has a level of ‘diagnosed illness’ equivalent to that of a 76-year-old woman in the wealthiest areas, while a 60-year-old man in the poorest areas of England will on average have a level of diagnosed illness equivalent to that of a 70-year-old man in the wealthiest areas.

How can local authorities reduce obesity? This review looks at 143 NIHR-funded studies on obesity that are relevant to local authorities and it covers a wide variety of areas in which local authorities can take action. The aim of the review is to help local authorities make sense of this research and use it to inform decision-making at a local level.

What is happening to life expectancy in England? Here we examine trends in life expectancy up to 2021, why these trends change and how the UK compares with other countries.

Views being sought to tackle inequality in medical devices. Call for evidence launched to discover if and how medical devices and technologies may be exacerbating inequalities in healthcare.

The NHS’s role in tackling poverty Poverty affects one-fifth of the UK population. This virtual conference builds on The King’s Fund’s work for our 2021 report exploring how the NHS can maximise its contribution to tackling poverty, within its resources and with its partners.

Ambitious for change: research into NMC processes and people’s protected characteristics This report outlines the findings from research into why some professionals have different experiences of NMC's processes. The report aims to understand why these differences exist and the impact they have on the workforce. The findings highlight opportunities to improve regulatory activities and ensure processes are fair. They also draw attention to how inequalities that cut across the health and social care sector and exist in wider society are contributing to the disparities.

Towards a new partnership between disabled people and health and care services: getting our voices heard. Disabled people face poorer experiences of – and worse access to – health and care services than people who aren’t disabled and these health inequalities have been exacerbated by the Covid-19 pandemic. In this context, it’s vitally important to include disabled people in planning, designing and developing health and care services. This King's Fund long read, with Disability Rights UK sets out what we found out about how disabled people are currently involved in health and care service design, and what good might look like.

How we can help

We have a multidisciplinary team advising NHS commissioners and providers on all aspects of tackling health inequalities, ranging from:

  • advising on the new legal framework and compliance with the relevant statutory duties, particularly in the context of service reconfiguration;
  • addressing workforce inequalities;
  • taking action on patient safety to reduce health inequalities;
  • the role of the Care Quality Commission in tackling health inequalities; and
  • lessons to be learnt from the Covid-19 pandemic.

If you wish to discuss any queries you may have around health inequalities please contact Olivia Carter or Julia Jones.

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Information Sharing/Data 

Publications/Guidance

Secure data environment for NHS health and social care data - policy guidelines. Department of Health and Social Care policy guidelines set out rules for how secure data environments will be used to access NHS health and social care data for research and analysis. They: provide an introduction to secure data environments; add detail to the policy commitments made in the "Data saves lives: reshaping health and social care with data" strategy; describe the minimum requirements that secure data environments must meet; outline how secure data environments will be delivered; and communicate the next steps for secure data environments relating to public and patient engagement, technical and accreditation guidance, and delivery and implementation.

For more information contact  James Cassidy or Jane Bennett

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Inquests 

Bevan Brittan Events

Recent developments and causation in inquests - 11th October

Bevan Brittan Updates

Care Home Providers: Lessons Learnt From Recent Inquests

If you wish to discuss any queries you may have around inquests, please contact Toby De MellowSamantha Minchin or Claire Leonard

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Mental Health 

Publications/guidance 

LPS Consultation Update. The LPS implementation team have sent out their latest email update on progress with the consultation. They say they have received over 650 responses and are currently collating and analysing responses. Once this has been done a further update is expected later this year.

Electronic bills in Court of Protection cases – Pilot in the Senior Courts Costs Office. From 1 November 2022 until 28 April 2023, professional deputies appointed by the Court of Protection, their legal representatives and other legal professionals involved in Court of Protection cases, may file their bills in respect of general management and other applications where the relevant authority has been obtained from the Court of Protection in electronic spreadsheet form.

The impact of body image on mental and physical health This report states that the government must speed up the introduction of a promised licensing regime for non-surgical cosmetic procedures to prevent vulnerable people being exploited. The report identifies a rise in body image dissatisfaction as the driver behind a new market that to date has remained largely unregulated.

Cases 

South Gloucestershire Council & DN & S [2022] EWCOP 35. Applications concerning placement for a 17 year old with a diagnosis of Autistic Spectrum Disorder, severe learning difficulties, and Tourette’s Syndrome, after he attacked staff at his current placement.

AC and GC (Capacity: Hoarding: Best Interests) [2022] EWCOP 39. Application by local authority about the return to home of AC, a 92-year-old, in circumstances where her son, GC, who had been her main carer, had hoarding issues and where both of them lacked capacity in certain areas.

Hull City Council v KF [2022] EWCOP 33. Capacity and best interests decision concerning whether KF has capacity to have sexual relations with KF, a man who has sexually assaulted her in the past.

EM, Re [2022] EWCOP 31. Judgment from Mostyn J clarifying points around participation of P, anonymity and the correctness of the standard transparency order.

A Mental Health NHS Trust v BG [2022] EWCOP 26. Reserved judgment following declarations that it was in BG’s best interests for no further treatment and no hydration or nutrition against her wishes.

Legislation

Mental Health Units (Use of Force) Act 2018 (Commencement No.3) Regulations 2022 (SI 2022/909 (C.66)) These Regulations bring into force, on 18 August 2022, the Mental Health Units (Use of Force) Act 2018 s.12, which requires a police officer to wear a body camera, if reasonably practicable, when entering and assisting staff in a mental health unit.

News

Safety fears prompt NHS trusts to support troubled independent provider.

Bevan Brittan Events

Recent developments to the MHA 1983 and MCA 2005 - 20th September

How we can help

We are experts in advising commissioners, providers and care co-ordinators on the relevant legal frameworks. We deal with complex issues such as deprivation of liberty, state involvement, use of CCTV monitoring, seclusion, physical restraint and covert medication. We can help providers with queries about admission and detention, consent to treatment, forensic service users, transfers, leave, discharge planning and hearings. We can advise commissioners on all matters concerning commissioning responsibility, liability and disputes. For more information click here

If you wish to discuss any mental health issues facing your organisation please contact Simon Lindsay, Hannah Taylor, or Stuart Marchant

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Primary Care  

Publications/guidance

New claims baseline to support future improvements in general practice care. Analysis of the data from the first year of an indemnity scheme for general practice has identified that quicker and more accurate diagnosis, and improved prescribing processes could result in better patient outcomes, a report from NHS Resolution published today has found. The report provides a comprehensive review of the first year of the Clinical Negligence Scheme for General Practice (CNSGP). CNSGP is the indemnity scheme managed by NHS Resolution, which covers NHS primary care in England for incidents occurring after 1 April 2019.

How to make change happen in general practice The growing crisis facing general practice, where demand is outstripping available workforce, means that as integrated care systems take on responsibility for NHS resources, understanding how to make change happen in general practice is vital.

GP practice readiness checklist is for general practices to use to ensure they are prepared for the upcoming changes from 1 November 2022, which will give patients access to their prospective(ie future) GP records. It signposts to relevant resources that include an updated RCGP GP Online Services Toolkit, a suite of videos and learning from early adopter sites.

Bureaucracy busting concordat: principles to reduce unnecessary bureaucracy and administrative burdens on general practice The government made a public commitment as part of the 2020 to 2021 GP contract update to jointly review bureaucracy in general practice with NHS England. The intention of the review was to reduce the burden on general practitioners and primary care teams, releasing more time to focus on patient care. The concordat is a complementary piece of work to the review and outlines seven principles to help reduce unnecessary bureaucracy and administrative burdens in general practice. It was developed with the input of stakeholders including the British Medical Association (BMA) and Royal College of General Practitioners (RCGP).

GP staff survey summary report - General Practice Data for Planning and Research (GPDPR). NHS Digital carried out a national online survey with general practice staff on general practice data for planning and research, burden reduction and health data use. Here is a summary of the results.

Primary and community care: Improving patient outcomes. A House of Lords Library In Focus briefing details primary and community care services and examines their impact on patient outcomes. It also considers recent government policy which has sought to improve these outcomes and discusses several proposals for reforming such services.

Access to health records. From 1 August 2022, the management of applications made under the Access to Health Records Act 1990 (AHRA) for deceased patient records has changed.

Long COVID resources for primary care This document provides healthcare professionals in primary care with information to support patients who are living with long COVID along with resources to support communications with communities.

Bevan Brittan Videos

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 five videos in this series are available to watch now. See below:-
Consent - Daniel Morris
Medical record keeping - Ben Lambert
Administrative errors - Susan Trigg
What to do if you receive a complaint or claim - Joanne Easterbrook
Common pitfalls - Helen Carrington

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 

How we can help   

We can offer support and advice on managing contractual and operational issues affecting and arising from the delivery of primary care services, including complaints, inquests and claims, regulatory scrutiny, 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 issues in primary care then please contact  Joanne Easterbrook, Susan TriggVincent Buscemi or Ben Lambert. 

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Regulation  

Publications/Guidance 

Safer care for all: Solutions from professional regulation and beyond. A Professional Standards Authority report highlights challenges affecting the quality and safety of health and social care across the UK and puts forward recommendations to ensure safer care for all. It recommends the appointment of an independent Health and Social Care Safety Commissioner (or equivalent) for each UK country, and addresses tackling inequalities; regulating for new risks; facing up to the workforce crisis; and accountability, fear and public safety.  

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

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Social Care  

Publications/Guidance 

Accountabilities and structures in the health and care system How does the health and care system function – and how do responsibilities and accountabilities in the system flow?

Adult social care workforce This research briefing gives an overview of key issues and policy concerning the adult social care workforce in England

Building capacity and capability for improvement in adult social care. The Kings Fund look at how local authorities in England improve the quality of adult social care.

Agency fees for social care: key findings This survey of independent providers shows the extent to which the Covid-19 pandemic has exacerbated the reliance on agency staff, reaching a point of unsustainability for the sector. It ran between 16 May and 1 June 2022 and received 95 responses from a diverse range of service providers representing circa 70,000 registered beds.

There is no community without people: the staffing challenges facing community health services and how we can address them This briefing sets out the key workforce pressures facing community health providers, alongside suggested solutions and policy enablers to increase workforce capacity in the sector. The content has been directly informed by the views and experiences of community provider leaders.

System on a cliff edge: addressing challenges in social care capacity This report, based on a survey of NHS leaders across England, says staffing gaps and a lack of capacity in social care are putting the care and safety of patients in the NHS at risk. More than nine in ten NHS leaders warn of a social care workforce crisis in their area that they expect will get worse this winter. Almost all NHS leaders say that the most impactful solution would be better pay for social care staff and call for the government to increase investment in social care as a priority.

Distribution of funding to support the reform of the adult social care charging system in 2023 to 2024 The government is introducing a new adult social care charging framework from October 2023. This consultation seeks views on proposals for distributing funding to support the first year of delivery of adult social care charging reform in 2023 to 2024. There are proposals for: distributing funding for needs and financial assessments; the extension to the means test; and the cap on care costs. The consultation closes at 11.45pm on 23 September 2022.

Bringing hospital care home: virtual wards and hospital at home for older people This report explores the potential benefits, limitations, and current scientific evidence to be considered when providing a safe, effective, and person-centred alternative to hospital inpatient care for older adults. This publication highlights how ‘virtual wards’ are being funded and implemented. It explains the various definitions of the term ‘virtual wards’ as used in different parts of the UK and describes the face-to-face care delivered by a multidisciplinary team, combined with some remote monitoring.

Overseas hiring spree planned for care homes in England amid winter fears.Foreign workers could be recruited for care homes in England under government plans amid concerns about staff shortages this winter. The health secretary, Steve Barclay, wants the overseas recruitment spree to include sending NHS managers to countries such as India and the Philippines to hire thousands of nurses

Covid death payments unavailable for staff who died in most recent waves. The families of any NHS and social care staff who died from covid in the most recent waves will not be eligible for the covid death assurance scheme launched at the start of the pandemic, it has emerged. The scheme closed on 31 March, despite pleas from the Royal College of Nursing to keep it open. Since it was set up in April 2020, it has paid out £60,000 lump sums to the estates of 688 workers. A further 42 cases have been declined and 29 applications are still being processed. The scheme has been notified of six deaths which occurred in the first three months of 2022 and families have until 31 March 2023 to make claims for any relatives who died before the 31 March 2022 cut off date.

Adult social care principles for integrated care partnerships Provides guidance on how integrated care partnerships (ICPs) and adult social care (ASC) providers are expected to work together.

News

Odds stacked against it: how social care struggles to compete with supermarkets on pay. Pay is a key reason for the social care workforce crisis, says Simon Bottery (Senior Fellow in Social Care at The King's Fund). Nearly 400,000 care workers would be financially better off working in supermarkets.

How we can help 

For ways in which we can help with Social Care issues click here.

If you wish to discuss any queries you may have around social care please contact Siwan Griffiths.

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General 

Publications/Guidance 

Role of the independent sector in elective care recovery Given the role anticipated for the independent sector in elective care recovery from the coronavirus pandemic, this long read explores the sector’s role to date, looks at how this has changed since the pre-pandemic period, and considers what it might mean for patients waiting for different types of treatments, and living in different parts of England.

Where does the buck stop? Understanding accountabilities and structures in the national health and care system in England The Health and Care Act 2022 and concurrent reforms to the public health system have introduced a range of changes and some simplifications to the landscape of national bodies in the health and care system. Here, The King's Fund explains the core functions of the national bodies with the most significant role in setting policy for and shaping the operation of the health and care system. We also look at how these organisations are held accountable for carrying out those functions and the extent to which central government can direct them.

NHS trials smart goggles to give nurses more time with patients. High tech goggles will be worn by community nurses on home visits to free up time with patients, as part of a cutting-edge NHS pilot.

NHS England reveals six targets for ICSs this winter. NHS England  identified six key metrics it will use to monitor the performance of every integrated care system this winter. The 2022-23 winter letter includes a broad range of measures to boost capacity across the system through a mix of new hospital beds, increased non-acute capacity and virtual wards and a boost in urgent and emergency call handlers.

Care of transgender and gender diverse adults within obstetrics and gynaecology. The Royal College of Obstetricians and Gynaecologists has opened a consultation on a draft guideline relating to the care of transgender and gender diverse people.

Migrant health guide Advice and guidance on the health needs of migrant patients for healthcare practitioners.

Update on Covid-19 public inquiry On 21 July 2022, Baroness Hallett, chair of the UK Covid-19 Public Inquiry, officially launched the inquiry. This briefing provides an update on the inquiry including an update on the planned approach and timetable, dates for the first procedural and public hearings, and details of the modular structure of the inquiry.

Guidance on the preparation of integrated care strategies. Guidance developed by the Department of Health and Social Care, Local Government Association and NHS England, in partnership with the Care Provider Alliance, for integrated care partnerships (ICPs) on integrated care strategies and how integrated care providers and adult social care providers are expected to work together. The Health and Care Act 2022 builds on the work of existing non-statutory integrated care systems by establishing NHS bodies known as integrated care boards (ICBs) and requiring the creation of ICPs in each of the 42 ICB areas across England.

Women in prison. Women represent less than 5 per cent of the total prison population. They are often sentenced to custody for non-violent, low-level but persistent offences, and are more likely than men to be sentenced for short periods of time. Female offenders are often the most vulnerable in society and have varied and complex needs. Many have experienced mental health problems, substance misuse, homelessness, abuse and trauma in their lives. The Ministry of Justice recognised these challenges in its 2018 Female Offender Strategy, which set out its strategic priorities to see fewer women coming into the criminal justice system; fewer women in custody (especially on short sentences); and a greater proportion of women managed in the community successfully, with better conditions for those in custody. This report assesses its performance to date against those priorities.

Has the Women’s Health Strategy listened to what women really need? The Women’s Health Strategy promises to address the poor experiences and worse health outcomes that women endure. The underlying cause of these issues is that the health system has historically been built by men for men. Consequently, women are often not listened to or believed by the health and care system. In this blog, The King's Fund considers whether this strategy will change the culture in the NHS of women not being listened to about their health and wellbeing.

NHS Prevent training and competencies framework Guidance for healthcare professionals about safeguarding vulnerable individuals from being drawn into terrorism. 

Bevan Brittan Updates

What is “Coercive Control” and why is it in the news?

UK Covid-19 Inquiry opens Module 2, investigation into government decision-making – will health bodies want to be Core Participants?

Bevan Brittan Events

Tricky issues involving police in hospitals - 27th September

An overview of the key changes set out in the Health and Care Act 2022 - 26th October

If you would like to sign up for any of our Bevan Brittan publications click here.

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