Health and Social Care Update - May 2012

Legal intelligence for professionals in health and social care

This Update contains brief details of recent Government publications, legislation, cases and other developments relevant to those involved in health and social care work, which have been published in the last month.

If you have been forwarded this update by a colleague and would like to receive it directly, please email Claire Bentley.

Care	Health and Safety
Children	Information and Data Sharing
Commissioning	Inquests
Employment/HR	Mental Health
Estates and facilities	Primary Care
Finance	Regulation
Governance	General

 

Care

Publications/Guidance
Care in the balance: a UNISON survey into staff/patient ratios on our wards. This survey asked nurses, midwives, healthcare assistants and other staff to chart their experiences including the pressures of a typical working day to reveal some insight into NHS working.

Inpatient survey 2011. This survey looked at the experiences of over 70,000 people who were admitted to NHS hospitals around England. The results of the survey will be used by NHS trusts to improve their performance and to understand their patients’ experiences, and the results will be used to support the CQC's regulatory, compliance and monitoring activities. 

Hospital discharge and black, asian & minority ethnic (BAME) carers. The purpose of this briefing is to improve the knowledge and practice of supporting BAME carers at the point of hospital discharge. It draws on expertise, knowledge and involvement of carers and professionals across London. 

End of life care: methods review. This review provides an overview of the range of research methods that have been commonly used in end of life care research and their relevance for social care. It provides a policy and service context for understanding end of life care research in social care and, using examples from relevant research, considers the advantages and disadvantages of different research methods and tools. The particular ethical challenges and practical issues that may arise are discussed along with some strategies and sources of support to address them. 

Caring in crisis: the impact of the financial crisis on nurses and nursing. This country-by-country report looks at the impact of the economic crisis on nurses and nursing in Europe. It illustrates the current and future challenges facing the nursing profession, and offers a view of the specific dynamics in each country, as well as a tool to take action and tackle these challenges. 

What do we know now that we didn’t know a year ago? New intelligence on end of life care in England. This report highlights areas where improvements have been made as well as where further action is needed to improve care for people who are dying. The publication is divided into 16 categories ranging from place of care and death to latest trends in different settings, different disease types, costs, quality of care, workforce and public attitudes.

Toolkit for improving care for frail older people. This is the third in a series of acute care toolkits which aims to improve the care of the frail older patient. The toolkit, produced in collaboration with the British Geriatrics Society, recommends procedures for both initial assessment on admission and later Comprehensive Geriatric Assessment. 

Prime Minister sets out challenges to new nursing forum. The Prime Minister has issued a call to action for frontline nurses across the country to search out best practice and share it across the NHS. Speaking at the first meeting of the Nursing and Care Quality Forum, the Prime Minister and Health Secretary Andrew Lansley outlined the push to free up nurses to provide the care patients and relatives expect. A range of measures were discussed by the forum, including: Hourly nursing rounds to ensure patients are checked on regularly and know when to expect a nurse; A patient feedback challenge backed by a £1m fund, where nurses and doctors can submit ideas on how best to use patient feedback. The best will be selected and shared; and Promoting leadership to make sure there is an authority figure for nurses and patients to put their trust in. 

If you wish to discuss any of the items raised in this section please contact Carlton Sadler.   

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Children

Publications/Guidance
Update on adults’ and children’s palliative care and funding for children’s hospices. Provides an update on the 2010/11 grant of £30m to the children’s palliative care sector to support local projects to improve services, giving a summary of the individual allocations. Around £19m was claimed by children's hospices, other children’s palliative care organisations and children's palliative care networks.

Consultant delivered care: an evaluation of new ways of working in paediatrics. This report contains an evaluation of new ways of working in paediatrics. It concludes that children would receive better care if they had 24/7 access to a consultant or equivalent senior doctor. The six-month project carried out a survey of all paediatric inpatient and neonatal trusts in the UK to look at the extent to which consultant delivered care models are already being used. Based on the results of this survey, in-depth site visits were conducted at 10 trusts to look at the impact of these ways of working on team members, resident consultants and a range of indicators.

Information requirements for Child Health information systems. Sets out details of the information requirements for the delivery of child health services as part of the future health and care system announced in the Health and Social Care Act 2012. The DH will now develop these information requirements into an outline business specification, detailing the technical requirements of a Child Health Information System (CHIS). 

Social determinants of health and well-being among young people. Health behaviour in school-aged children (HBSC) study: international report from the 2009/2010 survey This report concludes that widespread inequalities mean that many young people in the WHO European Region and North America are not as healthy as they could be. It aims to contribute towards a better understanding of the social determinants of health and well-being among young people, and providing the means to help protect and promote their health. 

Standards for children and young people in emergency care settings. This revised guideline provides healthcare professionals, providers and service planners with measurable and auditable standards of care applicable to all urgent and emergency care settings in the UK. This updated edition reflects changes in the way care is delivered: there is a new chapter focusing on mental health and substance misuse and the document takes a 'pathway' approach to aid a multi-professional workforce.

National Child Measurement Programme: Operational guidance for the 2012/13 school year. Delivery of the National Child Measurement Programme (NCMP) is a key element of the Government's plans to tackle the public health challenge of excess weight and, from April 2013, the surveillance component of the NCMP will be a mandated function of local authorities. During the current transition year, the NHS will continue to be accountable for the delivery of all public health programmes including the NCMP and for working with local authority colleagues to ensure that these programmes transition successfully. This annual guidance advises local providers of the NCMP on how the programme should be implemented. While there are no fundamental changes to the operational delivery of the NCMP from the previous school year (2011/12), the guidance has been amended in the light of findings from recent research, feedback from practitioners, and the significant reforms and transitions that are under way within the NHS. There are also a parental feedback tool and letter templates that can be edited to meet local needs in delivery of the NCMP.

Consultations
Social and emotional wellbeing - early years: consultation on the draft guidance. NICE is developing public health guidance on how the social and emotional wellbeing of vulnerable children aged under 5 years can be effectively supported through home visiting, childcare and early education. All registered stakeholders for the public health intervention guidance are invited to comment on the provisional recommendations. Organisations not registered as stakeholders are not able to comment. This consultation will take place between 20th April and 18th June 2012. .  

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Commissioning

Publications/Guidance
Using the Commissioning for Quality and Innovation (CQUIN) payment framework - guidance on new national goals for 2012-13. Guidance on two new national CQUIN goals have been introduced for use in 2012/13: Dementia goal, that incentivises the identification of patients with dementia and other causes of cognitive impairment, and the NHS Safety Thermometer goal that incentivises the measurement of harm from pressure ulcers, falls, urinary tract infections in patients with catheters and VTE.

What we know so far about the NHS Commissioning Board. This BMA briefing is part of a series which sets out what we know so far on a range of key topics following the government’s health reforms

Clinical commissioning group (CCG) authorisation: draft guide for applicants. This document is designed to help emerging CCGs develop clear plans to progress through the authorisation process and become an authorised CCG. It provides a detailed description of the criteria, thresholds and evidence for authorisation and sets out the three phases of authorisation: pre-application, application and Board Authority-led assessment. It then sets out the timetable for applications in four waves and outlines the possible outcomes: fully authorised; authorised with conditions; and established but not authorised (a shadow CCG).

Smart guides to engagement. These guides comprise the first of four in a series of 10 guides to engagement cover the social and economic benefits, dealing with LINks and local HealthWatch, and the role of lay members and patient representatives on Clinical Commissioning Group boards.

Commissioning occupational health (OH) services. This guidance has been published to assist occupational health leaders, HR directors and boards in commissioning OH services and understanding what commissioned OH services should be delivering for the organisation.

The Government's strategic objectives for the NHS Commissioning Board Authority. Andrew Lansley has written to Prof. Malcolm Grant, Chairman of the NHS CBA, setting out the Government’s strategic objectives for the NHS CBA and the basis against which the Authority will be held to account. The DH will hold the Authority to account for its performance against four strategic objectives, relating to:
  transferring power to local organisations;
  establishing the commissioning landscape;
  developing specific commissioning and financial management capabilities; and
  developing excellent relationships.
These objectives flow from the Authority’s role to prepare for the establishment and operation of the NHS Commissioning Board. They are relevant to the period when the Authority is operating (until October 2012) and also to the full NHS Commissioning Board when it is established, in its preparatory phase from October 2012 until March 2013. From April 2013, when the Board takes on its full statutory powers, Ministers will set their objectives, on behalf of the Government as a whole, through the mandate. Proposals for the mandate are currently being developed with the aim of consulting on them this summer.

Benchmark of out of hours - An overview across the services. This tool aims to allow anyone with an interest in out of hours services – whether service user, provider or commissioner – to see how their local service is performing compared to others. It was developed from the 4th round of the Primary Care Foundation’s national benchmarking exercise and includes data from 104 of the 151 English PCTs. The benchmark is based on detail summarised in over 40 indicators, including cost, quality, outcomes, timeliness and patient experience.

Bevan Brittan Updates
A robust and effective CCG Constitution . One of the key tests for any clinical commissioning group seeking authorisation from the NHS Commissioning Board will be that they have a constitution that is compliant with the requirements of the 2012 Act, and is “otherwise appropriate”.  In effect this means that the Commissioning Board must be happy with it!

If you require further information about any of the items raised in this section please contact David Owens. 

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Employment/HR

 

Publications/Guidance
Performance related pay awards for staff covered by the Pay Framework for Very Senior Managers (VSMs). Staff covered by the VSM pay framework are eligible to be considered for a performance related pay award. This letter outlines guidance which provides remuneration committees in SHAs, special health authorities, PCTs and ambulance trusts with the criteria for the awards for 2011/12.

Survey of NHS health professionals 2012. This joint union survey is asking RCN members working in the NHS about their views on pay and working conditions. The findings will be used to help inform the RCN’s next submission to the NHS Pay Review Body, which makes recommendations to the Government on the level of pay and pay-related terms and conditions for NHS staff. The survey closes on Friday 8th June 2012.

Briefing for MPs on EU working time regulation and the NHS. This briefing for MPs outlines employers' views of the European Working Time Directive (EWTD), ahead of a debate in Parliament on whether the EWTD was damaging to patient care.

NHS staff: social indicators. This briefing provides an overview of the make-up of NHS staff in England.

NHS pension scheme. This note looks at recent reviews of the NHS pension scheme.

NHS Pay Review Body - market facing pay: written evidence from the Health Department for England - April 2012. This publication presents the written and statistical evidence on market-facing pay submitted by the Department of Health to the NHS Pay Review Body.

Quality assurance of medical appraisers: recruitment, training, support and review of medical appraisers in England. This framework aims to assure the quality of the medical appraiser workforce, outlining processes for the recruitment, training and support of medical appraisers and methods by which their performance in the role can be reviewed.

Return to work guidance. This guidance aims to support the management of doctors returning to work after an absence, planned or otherwise. It includes advice for managing issues facing doctors returning to practice; practical checklists; recommendations for establishing an organisational policy; and recommendations for setting up an action plan for return to work.

Bevan Brittan Updates
Another social media storm. Another case has come through the courts relating to inappropriate Facebook usage by an employee.  As you may recall we reported on the rise of dismissal cases relating to employees' use of Facebook and other social media a few months ago.

News round up. Joanna Smart takes a look at some key employment law developments which took place in April, most notably the fact that the anticipated decision of the Supreme Court in Seldon v Clarkson Wright and Jakes was published on 25 April.

What are reasonable adjustments and when are claimant's feelings aggravated? In the case of Newcastle upon Tyne Hospitals NHS Foundation Trust v Bagley, the EAT has confirmed the position in regards to what constitutes a reasonable adjustment and also provided welcome clarification on when aggravated damages should become payable and what amounts to correct sums where these damages, and others, are concerned.

If you require further information about any of the items raised in this section please contact Julian Hoskins.  

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Estates and Facilities

Publications/guidance
Accelerating the release of public sector land for development: Main findings from the 2012 data collection from NHS trusts. The DH has published details of potentially surplus land for housing, currently owned by NHS organisations, which is no longer required nor likely to be needed for health service purposes in the future. DCLG has published a report on the progress of Accelerating the release of surplus public sector land: Progress report one year on to support housing. It also describes the support mechanisms that have been put in place to help departments dispose of land and the next steps for the Programme in the coming year. As set out in Budget 2012 sufficient land has been identified to meet the Government's ambition to dispose of land with the capacity to build over 100,000 homes by April 2015.

Bevan Brittan Updates
Department of Health disposal strategy – surplus land . The Department of Health yesterday published its finding on the number of parcels of land declared as surplus or potentially surplus current held by NHS trusts.

Service critical NHS property transfers. The Guidance issued by the Department of Health on 4 August 2011 states that aspirant Community Foundation Trusts, other National Health Service Trusts and Foundation Trusts (transferees) are to be given the opportunity to acquire the parts of the PCT estate deemed ‘service critical clinical infrastructure’. On 22 March this year, the Department of Health issued a draft Transfer Order (the Order) which is intended to effect these transfers.  This alert provides guidance in relation to this latest publication from the department .

If you require further information about any of the items raised in this section please contact  Rob Harrison or Mark Calverley.  

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  Finance 

Publications/Guidance
Work programme and scales of fees 2012/13: Health - April 2012. sets out the work that the Audit Commission plans to undertake at NHS trusts, PCTs and SHAs during 2012/13, with the associated scales of audit fees. The Commission states that the combination of outsourcing its in-house Audit Practice and internal efficiency savings means that it is able to pass on significant reductions in audit fees this year to audited bodies. See also the table of Individual fees for health bodies. These lower fees are fixed for five years irrespective of inflation.

Quality accounts: 2011/12 audit guidance. This guidance sets out what trusts will need to do to support the audit of their 2011/12 Quality Accounts. The audit requirement applies to all NHS acute and mental health trusts that produce a Quality Account for 2011/12, as well as the Isle of Wight PCT.

Department of Health and Monitor - joint supplementary accounting guidance. Following on from the month nine agreement of the balance exercise, which showed significant differences on both receivables and payables and income and expenditure, guidance has been prepared to clarify specific areas where the possibility of different interpretation by organisations has been identified. The clarifying guidance should therefore help to minimise any differences at the year end.

Maternity services pathway payment system: a simple guide 2012/13. This guide provides a summary of the proposed 2013/14 Payment by Results pathway funding system for maternity services. It identifies what the NHS needs to do during 2012/13 to prepare for its implementation.

NHS expenditure. This briefing note documents: NHS expenditure since 1948; a summary of the structure of the NHS and how it is financed; and describes how PCTs are allocated funding.

Building recovery in local communities. This joint letter from the Department of Health, the Home Office and the Ministry of Justice highlights new opportunities for joint working to improve outcomes and use resources more efficiently.

If you require further information about any of the items raised in this section please contact David Owens. 

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Governance

Publications/Guidance
Community services governance indicators: frequently asked questions. This document answers frequently asked questions relating to reporting requirements for both 2011/12 and 2012/13.

If you require further information about any of the items raised in this section please contact Vincent Buscemi.     

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Health and Safety

    

Publications/Guidance
Safe management of healthcare waste. An updated version of the safe management of healthcare waste guidance manual is now available. A number of issues needed clarifying to improve consistency of understanding and to advise of legislative changes that have come into force since publication.

Evaluation of the national Cleanyourhands campaign to reduce Staphylococcus aureus bacteraemia and Clostridium difficile infection in hospitals in England and Wales by improved hand hygiene. This study evaluates the impact of the Cleanyourhands campaign on rates of hospital procurement of alcohol hand rub and soap; reports trends in selected healthcare associated infections; and investigates the association between infections and procurement.

Supporting doctors to provide safer care: responding to concerns about a doctor's practice. The purpose of the document is to help responsible officers to understand and enact their statutory duty to respond effectively to concerns about a doctor's practice. It provides a generic framework, a model for establishing the level of concern and lists the essential components of an organisational policy to support a consistent, equitable and fair process.

If you wish to discuss any of the items raised in this section please contact  Joanna Lloyd.     

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  Information and Data Sharing

Publications/Guidance
The European Commission has co-financed a project to use the European Health Insurance Card in developing cross-border eHealth services, enabling secure access to patient information in different EU countries.

By definition: improving data definitions and their use by the NHS. This briefing highlights that differences in the recording of details for a patient who stays in hospital for less than 24 hours are a major cause of dispute between NHS commissioners and providers. It discovers that the same treatment may be recorded as an inpatient service at one hospital, or as an outpatient at another and that this variation can increase charges.

A&E data sharing audit underway. Announces that the DH is conducting an audit to see whether accident and emergency departments are collecting and sharing de-personalised data on violent assault with local partners. The audit determines levels of engagement with information sharing and the extent to which data sharing has become standard practice in A&Es. The audit is mandatory for all acute trusts including foundation trusts.

'Striking the balance' - Practical guidance on the application of Caldicott Guardian Principles to domestic violence and MARACs (Multi Agency Risk Assessment Conferences). This guidance assists those involved in information sharing between agencies on highest risk cases of domestic abuse. It sets out the the underlying ethical considerations so that tensions between confidentiality and information sharing may be resolved, highlighting the balance between maintaining the individuals’ confidentiality and privacy and wider considerations such as protection from harm.

Bevan Brittan Updates
First NHS Fine handed out for a breach of Data Protection. The Information Commissioner’s Office (ICO) has this week handed out the first fine to an NHS organisation for a breach of the Data Protection Act 1998.

If you wish to discuss any of the items raised in this section please contact James Cassidy.     

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Inquests

Bevan Brittan Events
Annual Inquest Update. 29 May 2012 : 9.30am Registration, Seminar 10.00 - 12.30. Location: London Chamber of Commerce and Industry, 33 Queen Street, London EC4R 1AP. Bevan Brittan's Annual Inquest Update will consider the important changes in case law over the past year. register your interest in this event

If you wish to discuss any of the items raised in this section please contact  Joanna Lloyd.     

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Mental Health

 

Bevan Brittan Mental Health Extranet.
Free resource for Bevan Brittan NHS clients. Bevan Brittan has a wealth of mental health knowledge it would like to share with NHS clients. We have therefore developed an online searchable extranet designed to bring various sources of mental health information and guidance into one place.

The extranet also contains a forum for use by members to share knowledge and information. Forum issues currently being discussed are:-
 New CTO Treatment arrangements
 Inhouse produced forms - not meeting the wording in the regulations
 Implied consent and capacity - can compliance mean consent?
 s37/41 restriction orders anddischarge criteria
 Nearest relative 
 Apologising post inquest 
Rise in the number of applications to the Tribunal recently?

Training 
We had an interesting lunch time talk from Paul Barber this month. If you would like to come along to any of our lunch time sessions just let me know. You can attend in London , Bristol or Birmingham.

If you would like to see what is coming up click here.

If you would like information about how to access the Bevan Brittan Mental Health Extranet please email Claire Bentley by clicking here.

Publications/guidance
Review of services for people with learning disabilities. The CQC has published a further 36 reports from a targeted programme of 150 unannounced inspections of hospitals and care homes that care for people with learning disabilities. The programme is looking at whether people experience safe and appropriate care, treatment and support and whether they are protected from abuse. A national report into the findings of the programme will be published later this year. 

The dementia voice nurse service pilot: overview of findings and learning from the evaluation of the two year pilot programme. This briefing looks at data gathered over a 24 month period and shows the value of employing a dementia specialist end of life nurse based within a housing and care organisation. The savings identified through the service has led to the Dementia Voice Nurse (DVN) not only becoming a core offering of the dementia support service in Westminster but also to the granting of further funding to allow Housing 21 to extend the service to two other local authority areas. It is estimated that the DVN service wholly or partly contributed to total cost savings of more than £314K over the two years, in terms of avoided hospital, residential and nursing home admissions and ambulance services. 

Gay and bisexual men’s health survey. With 6,861 respondents from across Britain, this is the largest survey ever conducted of gay and bisexual men's health needs in the world. It finds that many of their needs are not being met and that there are areas of concern - particularly in mental health and drug use - that have been overlooked by health services which too often focus solely on gay men's sexual health.

Improving the mental health of prisoners. NICE will develop guidance aimed at improving the mental health of people in prison, following the latest topic referral from the Department of Health. It is estimated that around 90 per cent of all prisoners have a diagnosable mental health problem, including personality disorders, and/or a substance misuse problem.

Investing in emotional and psychological wellbeing for patients with long-term conditions. This is a guide to service design and productivity improvement for commissioners, clinicians and managers in primary care, secondary care and mental health. The collation of evidence and emerging economic analysis, together with examples of service design and delivery in this guide, aims to assist in designing services, improving productivity and learning across disease-specific groups.

Long-term health gains: investing in emotional and psychological wellbeing for patients with long-term conditions and medically unexplained symptoms. A new Mental Health Network report brings together the evidence across diabetes, chronic obstructive pulmonary disease and coronary heart disease, plus medically unexplained symptoms, to present a business case for investing in psychological services. This briefing summarises the report and describes how primary and secondary health services can improve patient outcomes, while reducing the overall costs of care for the NHS.

Mental health and homelessness: planning and delivering mental health services for homeless people. This briefing sets out the policy context around tackling homelessness and addressing the mental health needs of homeless people. It also examines what considerations need to be made when planning, designing and delivering mental health services for homeless people and highlights examples of good practice. 

Practice Direction: First-tier Tribunal Health Education and Social Care Chamber: Statements and Reports in Mental Health Cases. This practice direction specifies the contents of the statements and the reports that are to be sent or delivered in accordance with rule 32. It replaces the previous Practice Direction on mental health cases dated 30 October 2008 with effect from 06 April 2012.

Room specifications recommendations for Tribunal Hearings. Following consultation with stakeholders and, in particular, NHS Mental Health Trust Chief Executives in November 2008, this document is intended to remind Administrators of the minimum requirements for rooms provided by the Responsible Authority for hearings conducted by the First-tier Tribunal when the Tribunal visits hospitals and hears cases in accordance with the Mental Health Act 1983 (as amended).

Guidance booklet: Reports for Mental Health Tribunals. This is the second edition of this booklet, and it takes account of changes to the practice direction that came into effect on 6 April 2012. There are three key changes:
a. In all cases involving a community patient whose case is referred to the tribunal, Responsible Clinicians are asked to give their assessment of the patients capacity to decide whether or not to attend, or be represented at, a hearing of reference. 
b. In cases involving patients on a conditional discharge, there is a new requirement that Responsible Clinicians and Social Supervisors send their reports directly to the tribunal;
c. Where the patient is under the age of 18, there are new requirements in relation to the Social Circumstances report. 

Cases
E (As personal representative of the estate of M, Deceased) v (1)St George's Healthcare NHS Trust (2) Wandsworth Primary Care Trust (3) South West London & St George's Mental Health NHS Trust (2012). £20,000 was awarded to the claimant in relation to the suicide of his son in June 2008, who had been seen by a variety of staff from each defendant after he presented at a hospital stating that he was depressed and wanted to commit suicide.

DD v (1) Durham County Council (2) Middlesbrough City Council [2012] EWHC 1053 (QB). The court refused to grant the applicant leave to bring civil proceedings under the Mental Health Act 1983 s.139, as there was no real prospect of establishing liability against the relevant approved mental health practitioners.

News
Strasbourg judges have got it wrong in case of man's mistreatment in custody: judgment in MS v UK from European court leaves publicly funded authorities threatened with litigation from all sides. Article by Rosalind English in the Guardian. She argues that the ruling in MS v UK will leave publicly funded authorities at risk of increased litigation and that the judgment is a "prime example" of using Art.3 ECHR as a social and economic right rather than a basic civil right.

Patients with learning disabilities receive poorer care, doctors’ poll shows. A poll carried out on behalf on the GMC found that most doctors believe that patients with a learning disability receive poorer care than rest of the population. In response to this, the GMC have developed an online resource that provides guidance and support to GPs treating patients with learning disabilities.

CQC publishes 36 reports from its review of services for people with learning disabilities. The Care Quality Commission has published a further 36 reports from a targeted programme of 150 unannounced inspections of hospitals and care homes that care for people with learning disabilities, which looked at whether people experience safe and appropriate care, treatment and support and whether they are protected from abuse. A national report into the findings of the programme will be published later this year. The inspections focused on two outcomes relating to the Government’s essential standards of quality and safety: the care and welfare of people who use services, and safeguarding people who use services from abuse. Inspectors found major concerns at five locations: Assessment and Intervention Service (Birling Centre) (Kent and Medway NHS & Social Care Partnership Trust); 9 Victoria Street (Derbyshire CC); Elmsmead (Voyage Ltd); Cheswold Park Hospital (Riverside Health Care); and Willes Road (Turning Point). The full reports are available on CQC's website (see reports dated 25 April).

If you wish to discuss any of the items raised in the above section please contact Simon Lindsay. 

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Primary Care

Publications/Guidance
Choice of GP practice: Guidance for all PCTs - covering Outer Boundaries, Open and Closed Lists and aspects of the Patient Choice Scheme. Provides more detailed guidance on issues around choice of GP practice that affect all PCTs. Specifically, it covers the legislative changes implementing outer boundary areas and the new list closure procedures, as well as the aspects of the Patient Choice Scheme which could affect PCTs in those areas not participating in the piloting arrangements. It should be read alongside the document published on 4 April 2012 Choice of GP practice: Further guidance: The Patient Choice Scheme.

Investigating the prevalence and causes of prescribing errors in general practice: the PRACtICe study. This study of GP prescribing has found that while the vast majority of prescriptions written by family doctors are appropriate and effectively monitored, around 1 in 20 contain an error. It goes on to recommends a greater role for pharmacists in supporting GPs, better use of computer systems and extra emphasis on prescribing in GP training.

Baseline spending estimates for the new NHS and public health commissioning architecture. This briefing summarises the Department of Health document published on 7th February 2012 on baseline spending estimates on public health. It also gives the LGA's key messages in relation to public health funding and provides Chief Executives and Directors of Finance with advice on how they can assure themselves that the PCT estimate of public health spending will be adequate to meet the future resource requirements for public health from 2013.

On line benchmark for out of hours services. This tool aims to allow anyone with an interest in out of hours services – whether service user, provider or commissioner – to see how their local service is performing compared to others. It was developed from the fourth round of the Primary Care Foundation’s national benchmarking exercise and includes data from 104 of the 151 English primary care trusts. The benchmark is based on detail summarised in over 40 indicators including cost, quality, outcomes, timeliness and patient experience.

Direct access to diagnostic tests for cancer: best practice referral pathways for general practitioners. This guidance aims to help GPs in determining which patients would be suitable for direct referral to local services providing the diagnostic tests. It deals specifically with the circumstances and symptoms that may warrant such referrals and is aimed at health care professionals across primary and secondary care and those who both provide and commission services.

Legislation
Primary Medical Services (Patient Choice Scheme) Directions 2012. These Directions set out the requirements on PCTs considering establishing patient choice scheme arrangements. They come into force on 30 April 2012 and cease to have effect on 1 April 2013.

Primary Medical Services (Directed Enhanced Services) (England) (Amendment) Directions 2012. These new DES Directions came into force on 1 April 2012. They replace the 2010 DES Directions. 

News
Payment for GP practices in recognition of underspend in 2010-11. The DH has announced that following negotiations between the GPs’ Committee of the BMA and NHS Employers, ministers have signed off a new method for calculating dispensing fees. As part of the negotiated settlement, ministers have also agreed that a one-off payment of £10m should be made across GP practices in England. This payment, funded by the DH, is in recognition of the dispensing and personally administered fees underspend in 2010-11.

If you wish to discuss any of the items raised in the above section please contact David Owens.  

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Regulation

  

Publications/Guidance
Strategic review of the Nursing and Midwifery Council (NMC): interim report. This interim report focuses on regulatory purpose, leadership, governance, decision making and operational management. It sets out 16 recommendations to help the NMC carry out its regulatory role better in the future.

If you wish to discuss any of the items raised in this section please contact Carlton Sadler.

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General

Publications/Guidance
The waiting game: the results of Patients Association research into elective surgical procedures. This research shows an increase in waiting times for surgical procedures and a decline in the number of operations being carried out. It calls for more transparency about waiting times in individual clinical areas.

The General Medical Council (GMC) has released a guidance setting out the expectations of doctors when they use social media as part of a consultation on explanatory guidance which includes revisions and new documents.

The Department of Health has published new guidance on the Cancer Drugs Fund, which aims to help speed up access to drugs needed by cancer patients. In most cases patients should be able to access drugs within a matter of days of an application being made to the Fund.

Acronym buster. The NHS Confederation has published an NHS acronym buster that is designed to help you quickly get to grips with the many acronyms used in the NHS, and take the online quiz to test your NHS knowledge. It is set out alphabetically so you can easily look up what a set of initials stands for, and includes acronyms for both existing and new NHS organisations. The acronym buster is part of the new NHS Handbook 2012/13.

Clinical Negligence Scheme for Trusts (CNST) cover for independent sector providers in 2012-13 - update. This letter provides an update to the CNST cover for independent sector providers in 2012-13 has been published. All standard acute contracts in place with independent sector providers with an expiry date of 31st March 2012 must be extended and the revised expiry date will be 30th June 2012.

Attributing the costs of health & social care Research & Development (AcoRD). AcoRD establishes a mechanism for the Department of Health to meet some of the costs of charity-funded research in the NHS, for charities that are members of Association of Medical Research Charities. The agreement recognises the contribution medical research charities make to excellent research in the NHS. The guidance clarifies the distinction between the three categories of costs associated with non-commercial research studies: research costs; NHS support costs; and treatment costs.

Nutrition screening survey in the UK and Republic of Ireland in 2011. This is the fourth annual nutritional screening report and it reveals that malnutrition is not just a problem amongst older people, as it affects 26% of those aged between 20-29 years old who are admitted to hospital. The report highlights the need for consistent and integrated strategies to detect, prevent and treat malnutrition to exist within and between all care settings, not just in hospitals.

Cases
R (De Almeida) v Kensington & Chelsea RLBC [2012] EWHC 1082 (Admin) (Admin Ct). The court held that too high a threshold had been applied by a local authority when deciding that an individual terminally ill with AIDS was not entitled to accommodation and support pursuant to s.21 of the National Assistance Act 1948.

Consultations
Long term conditions. Developing a cross-government strategy. The DH has issued an informal consultation on its development of a Long Term Conditions Strategy that will set out a vision for how services such as health, social care, education, housing and others can work together to improve life chances and outcomes for people living with long term conditions. This vision will cover helping to prevent or delay the onset of conditions, preventing deterioration of conditions and helping to develop joined up services to support people living with long term conditions. The strategy won’t cover specific detail of how services are delivered. The closing date for comments on what should be in the strategy is 15 June 2012. DH aims to publish the Strategy by the end of 2012; it will apply to England only.

Responsible officers in the new health architecture: a public consultation on the amendments to the Medical Profession (Responsible Officers) 2010 Regulations. Proposals to ensure the language competence of doctors have been put forward as part of a consultation on regulations governing the role of responsible officers. Under the proposals, responsible officers would work with the General Medical Council to ensure doctors working in their organisation have all the right checks including making sure they understand NHS processes and medicines. It is aimed at ensuring that the Medical Profession (Responsible Officers) Regulations 2010 are appropriate for the new health and care structures and that patients continue to be protected through the evaluation of fitness to practise and monitoring of conduct and performance of doctors. The deadline for comments is 25 July 2012.

Legislation
Queen's Speech 2012. The Queen has outlined the Coalition Government’s legislative programme for the next year, on the State Opening of Parliament. The proposed Bills include: a Draft Care and Support Bill that aims to modernise adult care and make access to support clearer and more equal. This will include giving people greater choice and making councils adapt the services they offer to people's needs and experiences; and a Public Service Pensions Bill that implements controversial reforms to public sector pensions. Moves public sector pensions over to a career average scheme and extends the age at which members can draw their pensions. The Government says this will make them sustainable, with costs shared between employers, workers and taxpayers 'more fairly'. See also the Briefing notes on the announcements.

News
The Health Secretary, Andrew Lansley, has sent a letter to Death Certification National Steering Group members advising of a delay until April 2014 of full implementation of the proposed new local medical examiner (ME) service.

A National Institute for Health Research School for Public Health Research has been set up by the Department of Health. The Institute aims to: narrow the gap between the users and suppliers of research; undertake applied translational research; and increase the evidence base for effective public health practice. It has a budget of £20m over five years.

Overnight discharges from NHS hospitals to be examined. The BBC reports that the Government is to investigate allegations that hospital patients in England have been discharged overnight to free up beds. The Times newspaper discovered, via Freedom of Information requests, that 100 NHS trusts sent 239,233 patients home last year between 23:00 and 06:00. NHS medical director Prof Sir Bruce Keogh said people should be sent home only when it was appropriate and safe.

Bevan Brittan Updates
Cookie crunch: Is your website ready for the 26 May deadline? By 26 May 2012, all UK organisations that operate a website will need to obtain consent from visitors to its website in order to continue using cookies. The EU rules on the use of internet cookies changed following amendments made to the E-Privacy Directive. Those changes were implemented in the UK last year following amendments to the Privacy and Electronic Communications (EC Directive) Regulations 2003.

Public Services (Social Value) Act 2012. Elizabeth Cooper considers the new Public Services (Social Value) Act 2012 and how far a public body can take non-commercial considerations into account when procuring public contracts. 

Under the microscope – Reform of pathology services. The Carter Report advised on savings and service improvements that could be made within Pathology Services. In this article we review the options available to the NHS as they strive to optimise the standard of service provided.

If you wish to discuss any of the items raised in this section please contact Claire Bentley.

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