Health and Social Care Update - August

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	Information and Data Sharing
Children	Inquests
Clinical Risk	Mental Health
Commissioning	Obesity
Employment/HR	Primary Care
Estates and Facilities	Prison Health
Finance	Public Health
Foundation Trusts	Regulation
Governance	General

 

Care

Publications/Guidance
Winterbourne View Hospital - a serious case review. South Gloucestershire’s multi-agency Safeguarding Adults Board (SAB) has published the independent Serious Case Review into the events at the Winterbourne View private hospital. The review was commissioned by the SAB following the disclosure last year of the abuse of adults with learning disabilities and autism at the 24-bed private hospital owned and operated by Castlebeck Ltd. Prepared by independent adult safeguarding expert Margaret Flynn, the review shows that the abuse at Winterbourne View Hospital resulted from serious and sustained failings in the management procedures of Castlebeck Limited. It also identifies where other organisations’ systems and procedures fell short in commissioning patient care, and in reviewing and safeguarding the wellbeing of patients before and during their stay at Winterbourne View hospital.

Adult social care: LGO – the single point of contact for complaints. The Local Government Ombudsman (LGO) has published a report on lessons learned from complaints about adult social care providers. The report aims to share insights across a broad range of complaints to help improve services, including making the complaints process more efficient, ensuring vulnerable adults are protected and providing access to accurate information to help make better care choices.

Caring for our future - reforming care and support. This White Paper and the associated draft Bill (see below) set out proposals for the reform of adult social care and support. The proposals include:
  a Universal Deferred Payments scheme enabling councils to lend money to individuals that need care, and to recoup the money when the house is sold after the person’s death;
 a legal entitlement to a personal budget;
a duty to incorporate preventative practice and early intervention in care services;
 a number of new duties on local authorities, such as a duty to develop and maintain a diverse range of high quality care providers locally;
 trailblazer areas to develop new ways of investing in supporting people to stay active and independent, such as Social Impact Bonds;
 a national minimum eligibility threshold for access to care, and a similar threshold for support for carers;
 pilots to test the benefits of direct payments for people in residential care;
 the transfer of £300m (£100m in 2013/14 and £200m in 2014/15) from the NHS to social care to support the transformation of local services and promote better integrated care for patients and service users; and
 the NHS will be required to work with local authorities and local carers' organisations to agree plans and budgets to identify and support carers.

The DH has published a number of other documents alongside the White Paper, including:
 Draft Care and Support Bill: revokes and replaces existing social care laws and provides the legal framework for some of the main principles of the White Paper; it also includes some health measures on the establishment of the Health Research Authority and Health Education England. The Bill will be introduced into Parliament in late 2013 with a view to it coming into force in April 2015;
 Caring for our future: progress report on funding reform: the Government accepts the principles of the Dilnot Commission's model. It intends to base a new funding model on these principles but is unable to commit to introducing a new system at this stage. Funding reform will be considered at the next Spending Review; and
 Reforming the law for adult care and support: The Government’s response to Law Commission report 326 on adult social care: formal response to the report that lays the foundations for the legal framework set out in the draft Care and Support Bill.

White Paper on social care and funding update - LGA on the day briefing. Summarises the White Paper on the reform of adult social care and the draft Care and Support Bill, and highlights the key messages for local authorities.

Developing the use of direct payments in residential care. The DH is calling for expressions of interest from local authorities that would like to become trial sites for developing the use of direct payments in residential care. The closing date for submissions is 5 October 2012.

Undetected sight loss in care homes: an evidence review. This review of sight testing and sight loss in care homes found that lack of a national policy on eye health in care homes leaves many older people without basic eye care. It reveals that eye care and sight testing are neglected in care homes, leading to potential discrimination against those living in them compared to those who are cared for in the community.

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

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Children

Publications/guidance
Health visitor teaching in practice: A framework intended for use for commissioning, education and clinical practice of practice teachers. This framework aims to improve understanding of the role and the importance of the practice teacher, their preparation and responsibilities in order to deliver improved outcomes for children, families and communities aligned with the health visitor programme and service vision.

Protecting children and young people: The responsibilities of all doctors. This guidance from the GMC aims to at support doctors who have to deal with a wide range of complex child protection issues. It makes clear the responsibilities of doctors in this area and advises where they can turn for support.

Better services, better value: children's services clinical working group - final clinical report. This report sets out a proposed model of care for the future of children’s health services in south west London. It makes a number of recommendations for improving children's health services including: establishing a world-class children's hospital locally; making paediatrics expertise available in specialist children's A&E departments; and the development of children's community services to support children and their families.

Guidance on registration of healthcare at children's homes. This document is agreed joint guidance between Ofsted and the Care Quality Commission about the registration of children’s settings under the Care Standards Act 2000 and the Health and Social Care Act 2008, including children’s homes that provide health activities. It clarifies what children’s settings will need to register and how Ofsted and CQC will manage this registration process.

Report of the Children and Young People’s Health Outcomes Forum. This is a report from the Children and Young People’s Health Outcomes Forum giving proposals on how health-related care for children and young people can be improved.

If you wish to discuss any of the items raised in this section please contact Penelope Radcliffe or Deborah Jeremiah.   

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Clinical Risk     

Publications/Guidance
Falls prevention resources published by the Royal College of Physicians. The Falls Prevention Resources pack comprises a collection of quality improvement best practice measures for assessing the impact of the number of falls in clinical hospital wards as well as preventing and managing falls.

Innovation and improvement in maternity services. This study looks at examples of innovative practice across England and shows how midwives are leading on improving services for women and families and generating savings. It concludes that it is possible to deliver high quality, safe and effective care when midwives are engaged and lead on innovation and emphasises the important role that clinical leadership plays in enabling innovation and improvement to take place.

Developing and sustaining a practice based strategy for reducing healthcare associated infections programmes: evaluation report. This evaluation report looks at a programme which aimed to enable clinically based project teams to implement a strategy for developing, changing and evaluating practice to reduce and prevent healthcare associated infections. It identified clinical leadership; effective strategic support; clinical team involvement; and use of practice development methods as key to successfully reducing healthcare associated infections.

The safer management of controlled drugs. This is the fifth annual report on the governance of controlled drugs, looking at the data collected from 2011. The report examines how the CQC and their partners have improved the management of controlled drugs and how changes in healthcare legislation are affecting the arrangements for safer management of controlled drugs. It also reports on the progress that has been made with the recommendations outlined in the 2010 report. Further recommendations to assure the safety of people who use health and social care services have also been made. Also published is a self-assessment tool to help PCTs measure their performance and identify ways in which they can improve their management of controlled drugs and improve safety. It includes a series of detailed questions around the safe management of controlled drugs, which PCTs can use to score their current practices.

Effect of Clinical Decision-Support Systems (CDSSs) on care and costs. This study aimed to evaluate the effect of CDSSs on clinical outcomes, health care processes, workload and efficiency, patient satisfaction, cost, and provider use and implementation.

Advice on risk prediction and stratification activities. This guidance is aimed at NHS, social care and partner agencies on the use of risk prediction and stratification activities in relation to information governance and how this can be undertaken with a secure legal basis.

National Early Warning Score (NEWS). The National Early Warning Score is a patient safety system consisting of a standardised bedside chart which uses universally recognised terminology to make it easier for clinical staff to recognise and respond to a patient whose condition is deteriorating. The system can be used in both acute and community care settings.

'How to' guides to monitoring quality during transition. This series of 'how to' guides is designed to assist current NHS organisations, and their supervisory and regulatory bodies in responding to quality risks and failures within a simple and single framework during this transition year. The series of guides will assist the current supervisory structures to maintain a focus on quality surveillance and assurance, provide the tools to assist in interventions, and support to mitigate service quality failures during 2012/13.

General damages awards to be increased by 10%. The Lord Chief Justice has announced a 10% increase in general damages awards to compensate for the pain, suffering, distress and inconvenience of negligence, defamation and nuisance victims. The increase will come into effect on 1 April 2013 at the same time as the Legal Aid, Sentencing and Punishment of Offenders Act 2012 comes into force. Adrian Neale has prepared an article for discussion on this topic. If you would like a copy please contact  Adrian Neale.

The instruction of experts to give evidence in civil claims 2012. The purpose of this guidance is to assist litigants, those instructing experts and experts in understanding best practice with regard to compliance with Part 35 of the Civil Procedure Rules (CPR or the Rules) and the overriding objective. Experts and those who instruct them should ensure they are familiar with CPR 35 and its associated practice direction (PD or PD35).

End of life diabetes care. This strategy aims to summarise a consistent but high-quality approach towards end of life care for people with diabetes by providing a series of clinical care recommendations. It builds on the Department of Health's end of life care strategy whilst focusing on the special issues and challenges provoked by end of life care for patients with diabetes.

Consultations
Damages Act 1996: the discount rate - how should it be set? This consultation relates to the methodology to be used by the Lord Chancellor and his counterparts in Scotland and Northern Ireland in independently setting the discount rate for personal injury damages in their respective jurisdictions. The consultation is aimed at people and organisations with an interest in personal injury claims and damages in the UK. Deadline 23 October 2012.

News
Catherine Dixon, the head of the NHS Litigation Authority, has stated that claims against the NHS are likely to rise as cases are pushed through ahead of changes to the conditional fee agreement structure which are due to be implemented in April 2013. Ms Dixon added that the reforms will eventually reduce the disparity between claimant and defence costs, but only after a period when more claims have to be settled.

Medical report cost recovery in last-minute Jackson change. The Legal Aid, Sentencing and Punishment of Offenders Act has been amended to allow recoverability of after the event premiums to cover the cost of expert medical reports in clinical negligence cases. The amendment follows an equality impact assessment which revealed that claimants could be prevented from bringing a serious injury claim because of the cost of expert reports.

Link between nurse staffing, burnout and hospital infections. Nurse burnout leads to higher healthcare-associated infection rates (HAIs) and costs hospitals millions of additional dollars annually, according to a study published in the August issue of the American Journal of Infection Control, the official publication of the Association for Professionals in Infection Control and Epidemiology (APIC).

Patients flood A&E as GPs cut surgery hours. Millions of patients are unable to get GP appointments in the evenings or at weekends as doctors cut back on out-of-hours care, NHS figures suggest.

NHS trusts 'breaking the law' by denying access to treatment. Chair of drugs rationing body says NHS trusts are circumventing legal obligations to save money.

£1.2m payout for 'freak' growth woman. The High Court has awarded £1.2m from an NHS Trust responsible for clinical negligence which resulted in a young woman suffering excessive growth, and associated physical and psychological problems, due to a failure to diagnose a pituitary tumour.

Healthcare provider prosecuted after patient death. The Health and Safety Executive (HSE) have prosecuted BMI Healthcare Limited, of Hounslow, London, for safety failings resulting in the death of Michael Walsh, 85, from Beaconsfield, in Buckinghamshire on 13 February 2009. Mr Walsh suffered from confusion and disorientation three days after an operation and fell three-and-a-half metres from the balcony outside his private room. He died from injuries including a fractured vertebra. The HSE investigation found that the hospital had not assessed the risks of patients falling from balconies in private rooms, or, taken adequate measures to control this risk. BMI were fined £100,000 and ordered to pay costs of £29,447. On 18 July 2012, Amersham Crown Court heard BMI Healthcare Ltd plead guilty to breaching the Health and Safety at Work etc Act 1974, s.3(1), which states "it shall be the duty of every employer to conduct his undertaking in such a way as to ensure, so far as is reasonably practicable, that persons not in his employment who may be affected thereby are not thereby exposed to risks to their health or safety".

The NHS in Wales faces a "Catch-22" situation because its current services are unaffordable - but it may not have enough funds to pay for major reforms either.

Health Service Ombudsman announces review of approach to potentially avoidable death cases. The Health Service Ombudsman, announced an external review of the way in which her organisation handles cases involving potentially avoidable death.

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

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Commissioning

Publications/Guidance
Clinical commissioning group 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 (shadow CCG).

Drug and alcohol recovery pilots: Lessons learnt from co-design and commissioning with payment by results. This document, which is aimed at local commissioners, partners, providers and service users, outlines the key findings and lessons learnt from the eight pilot areas that have worked with central government and experts to co-design local ‘payment by results’ (PbR) models for drug and alcohol recovery services.

Clinical commissioning in action . This publication shares learning from CCGs around England in the form of case studies. Each case study illustrates an example of successful outcomes and service provision.

When doctors and patients talk: making sense of the consultation. This report explores the main form of interaction between a patient and a clinician - the consultation. It offers an analysis of the current relationship and describes the potential for a more nuanced model for the consultation. It makes recommendations for commissioning bodies and service providers to develop programmes that will boost patient skills and confidence and also to support doctors who are keen to experiment with new ways of working. 

Resources for clinical commissioning groups (CCGs). These resources are part of the CCG Learning Network that provides online support, resources and information for proposed CCGs. These include guidance and process documents, toolkits and other information around authorisation, governance, establishment and commissioning support. 

COPD commissioning toolkit. This toolkit aims to make it easier to commission better outcomes for people with COPD by bringing together the clinical, financial and commercial aspects of commissioning in one place. Alongside the toolkit itself, service specifications and costing tools have also been published. It is part of the suite of tools and resources to help to implement the Outcomes Strategy for COPD and Asthma and NHS Companion document. 

Commissioning Outcomes Framework (COF). NICE has published a Commissioning Outcomes Framework (COF) that measures the health outcomes and quality of care (including patient reported outcome measures and patient experience) achieved by clinical commissioning groups. The COF will allow the NHS Commissioning Board to identify the contribution of clinical commissioning groups to achieving the priorities for health improvement in the NHS Outcomes Framework, while also being accountable to patients and local communities. It will also enable the commissioning groups to benchmark their performance and identify priorities for improvement. The first set of 44 indicators have been recommended by the COF Advisory Committee, covering areas such as enhancing the quality of life for those with long-term conditions, and care for those immediately after stroke and following hospital discharge. A selection of final indicators will be considered by the NHS Commissioning Board in Autumn 2012 for inclusion in the 2013/14 COF.
See also How to measure for improving outcomes: a guide for commissioners. These two slide sets aim to help CCGs make the best use of measurement to support them to commission for improved outcomes. The first set of slides introduces general concepts about approaches to measurement in health care, the uses of structure, process and outcome indicators, and how to achieve a good mix of indicators for commissioning. The second set looks specifically at how commissioners can build up sets of measures along whole pathways of care.

Consultations
Consultation on local authority health scrutiny. Seeks views on proposals to update the arrangements and regulations for local authority health scrutiny, to bring them into line with changes introduced by the Health and Social Care Act 2012. The proposals include: local authorities and the NHS to agree and publish clear timescales for making a decision on whether a proposal should be referred; a new intermediate referral stage to the NHS Commissioning Board for some service reconfigurations; local authorities to take account of the financial sustainability of services when considering a referral; and health scrutiny to obtain the agreement of full Council before a referral can be made. The consultation closes on 7 September 2012.

Sector regulation: an update on plans for consultation and implementation. This paper provides a forward look at proposed DH consultations, describing what the DH will consult on and when. It also sets the consultations in context by recapping the aims and key components of the health and care modernisation programme as a whole, and of sector regulation in particular. There is also a useful timeline.

Bevan Brittan Updates
Choice & Competition Framework: Can Monitor and the Commissioning Board fix the NHS market? Monitor and the NHS Commissioning Board Authority are working together on a choice and competition project with a view to launching a formal interactive Choice and Competition Framework document by the end of this year.  Their laudable intention is to support commissioners in ensuring good practice and promoting and protecting patient choice.

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
Rapid access to treatment and rehabilitation for NHS staff. Rapid access is a system which will secure rehabilitation and occupational health treatment for NHS employees with a view to facilitating a return to work which is as fast as practical and reasonable. This guidance is intended for trust boards making decisions about how to manage rapid access services for staff in their organisation. 

Pay framework for very senior managers in strategic and SHAs, PCTs and ambulance trusts. This framework has been updated to include the pay rates in the clustered SHAs.

How to use shift systems and workforce planning to effectively reduce costs. This guidance offers practical advice on effective ways to reduce agency costs through the use of workforce planning, shift systems and maintenance of appropriate staffing levels.

CfWI horizon scanning of future NHS workforce: briefing note. This briefing outlines the steps that the Government plan to take to promote change within the roles and skills mix in the NHS to improve access and quality, and reduce costs.

Ensuring education reform enhances patient outcome: providers' planning and driving a workforce budget of £5bn. This briefing looks at how the creation of Health Education England and Local Education and Training Boards provides the opportunity for employers to ensure that the £5 billion annual national investment in education and training delivers the best possible patient outcome.

Age discrimination ban in services and public functions for service providers and customers. The Home Office has published an updated guide in its series "Equality Act 2010: What do I need to know?" that outlines the key changes in the law made by the Equality Act 2010. 

Consultations
Consultation on future of audit staff in trusts. Seeks views on the future of quality assessment and quality improvement of health care. It focuses on the role and function of audit staff in trusts and not the ability and achievements of existing staff. The consultation closes on 17 September 2012.

News
Doctors leaders maintain that national terms and conditions are essential for doctors, amid signs of regional negotiations for other hospital staff.

NHS must 'get a grip' on workplace wellbeing. The Royal College of Nursing has said the Government must sit up and take notice of a new survey which found nurse staffing and workforce issues have a significant impact on satisfaction levels and patient care.

Bevan Brittan Updates
Holiday requests from sick workers: the debate continues. There has been yet another chapter in the thorny issue of whether or not a sick worker’s failure to request holiday affects their right to carry over holiday. Following a further appeal in the case of NHS Leeds v Larner [2012] EWCA Civ 1034 to the Court of Appeal, Alastair Currie reviews the decision and the impact this could have on holiday rights for sick  workers.

News Round up: July 2012. Jane Wallenstein looks at some of the big employment stories of July 2012, including the announced decision to charge fees in the Employment Tribunal and Employment Appeal Tribunal; the most recent statistics in employment litigation; an update on the position regarding maternity leave and surrogacy and, finally, a recent case which has further clarified the difference between the definitions of worker and employee.

Redundancy: do less people need to be employed to justify a dismissal by way of redundancy? This question was considered recently by the EAT in the case of Packman t/a Packman Lucas Associates v Fauchon UKEAT/0017/12, as Victoria McNeel explains in this article.

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

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Estates and Facilities

 

Publications/Guidance
Collaboration between registered providers and NHS trusts: building an asset. Under the healthcare reform plans, the NHS is being asked to save £20bn from their budget. In order to achieve this, the NHS is actively exploring ways in which it may dispose of land it owns that is now surplus to requirements. This briefing is aimed at those registered providers involved in developing extra care housing and how they can better engage in the process of the sale of NHS land due to come to the market in the next few years.

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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Publications/Guidance
English hospitals can improve their use of resources: an analysis of costs and length of stay for ten treatments. This study assesses whether or not the higher cost or length of stay is due to the type of patients that hospitals treat. Looking at ten conditions, it examined the cost and length of stay for every patient admitted to English hospitals during 2007/8. It found that even after taking account of age, disease severity and other characteristics, patients in some hospitals still had substantially higher costs or longer length of stay than others.  

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

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Foundation Trusts 

Consultations
The new NHS provider licence consultation. This provider licence will be a key tool for regulating providers of NHS services. It sets out various conditions providers must meet, including conditions relating to: pricing; preventing anti-competitive behaviour which is against the interests of patients; enabling integrated care; supporting commissioners to maintain service continuity; and the governance of foundation trusts. This consultation seeks views on the provider licence and it runs until 23 October 2012.

News
What else is coming up in the future? Over the coming weeks and months Monitor will be publishing a number of consultations and other documents related to their new role.

Bevan Brittan Updates
Health and Social Care Act 2012: Key reforms to Foundation Trust governance. The second Commencement Order for the Health and Social Care Act 2012 has now been published, bringing a number of key provisions into force on 1 October 2012.  Foundation Trusts and Aspirant Trusts will need to amend their constitutional and governance arrangements to reflect the changes summarised in this article.

Bevan Brittan Events
Health & Social Care Bill Seminar: Provider regulatory issues for Foundation Trusts - Exeter. 20 September 2012 : 10.00am - 12.30pm (Registration 9.30am). Location: The Rougemont Hotel By Thistle, Queen Street, Exeter, EX4 3SP.
The health and social care act 2012 is becoming  reality as more provisions come into force and  while much attention is currently on the commissioner changes the provision of services will also change significantly as the new regime comes in. This seminar enables you to get on top of the changes and gives you the keys to understanding the future. register your interest in this event.

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

Back to top  Governance 

Publications/Guidance
NHS Change Model. The model has been created to support the NHS to adopt a shared approach to leading change and transformation. It brings together collective improvement knowledge and experience from across the NHS into eight key components.

Improved NHS services through new perspectives: a toolkit for doctors and managers to improve quality for patients. This online toolkit aims to help implement positive change in NHS trusts. It offers a way of improving productive working between doctors and managers in a series of steps that requires conversations between all parties and identifies any development required.

Advice on risk prediction and stratification activities. This guidance is aimed at NHS, social care and partner agencies on the use of risk prediction and stratification activities in relation to information governance and how this can be undertaken with a secure legal basis.

NHS internal audit standards. These standards ensure that those responsible for establishing, delivering and reviewing internal audit across the NHS continue to do so within a consistent framework. These recently published standards took effect from 1st April 2011, replacing the existing standards issued in 2002 and they apply to all NHS organisations. The standards are principles-based with additional interpretation to reflect the NHS environment and governance structures. These standards are aimed at providers of internal audit services.

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

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 Information and Data Sharing

Publications/Guidance
Guide to health records access. The Patient Information Forum (PiF) has released a guide to Personal Health Records (PHRs) which highlights their benefits and sets out the challenges practitioners, managers, and patient organisations will face if they are to meet the government’s target of giving every patient access to their GP records by 2015.

Information held by a public authority for the purposes of the Freedom of Information Act. This guidance explains when information is considered to be 'held' by a public authority, for the purposes of the FOI Act.

Advice on risk prediction and stratification activities. This guidance is aimed at NHS, social care and partner agencies on the use of risk prediction and stratification activities in relation to information governance and how this can be undertaken with a secure legal basis.

News
Sensitive details of NHS staff published by Trust in Devon. A health trust in Torquay has been served with a £175,000 penalty after the sensitive details of over 1,000 employees were accidentally published on the Trust’s website, the Information Commissioner’s Office (ICO) announced today. Staff at Torbay Care Trust published the information in a spreadsheet on their website in April 2011 and only spotted the mistake when it was reported by a member of the public 19 weeks later. The data covered the equality and diversity responses of 1,373 staff and included individuals’ names, dates of birth and National Insurance numbers, along with sensitive information about the person’s religion and sexuality. The ICO’s investigation found that the Trust had no guidance for staff on what information shouldn’t be published online and had inadequate checks in place to identify potential problems.

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

Back to top  Inquests 

Publications/Guidance
Challenging coroners' decisions - Commons Library Standard Note. A House of Commons Library Standard Note sets out information regarding how to complain about the level of service received or the personal conduct of a coroner, and how to challenge a coroner's decision or the outcome of an inquest. 

If you require further information about any of the items raised in this section please contact  Joanna Lloyd or Nadia Persaud. 

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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:-
 Wrong warrant
 Recall of cto but recall no longer needed
 Renewal Query
 Consent to treatment provisions
If you would like information about how to access the Bevan Brittan Mental Health Extranet please email Claire Bentley by clicking here.

Training - If you would like to know about our lunch time training sessions just let Claire Bentley know. You can attend in London, Bristol or Birmingham.

Publications/Guidance
Winterbourne View Hospital - a serious case review. South Gloucestershire’s multi-agency Safeguarding Adults Board (SAB) has published the independent Serious Case Review into the events at the Winterbourne View private hospital. The review was commissioned by the SAB following the disclosure last year of the abuse of adults with learning disabilities and autism at the 24-bed private hospital owned and operated by Castlebeck Ltd. Prepared by independent adult safeguarding expert Margaret Flynn, the review shows that the abuse at Winterbourne View Hospital resulted from serious and sustained failings in the management procedures of Castlebeck Limited. It also identifies where other organisations’ systems and procedures fell short in commissioning patient care, and in reviewing and safeguarding the wellbeing of patients before and during their stay at Winterbourne View hospital.

Post-legislative scrutiny of the Mental Health Act 2007. The Government’s ‘Post-legislative assessment of the Mental Health Act 2007′ has been laid before Parliament. Between 3 and 5 years after an Act of Parliament has received Royal Assent, it is reviewed by the relevant Government Department and then by Parliament, to see how the law has worked in practice. Once an assessment has been submitted to Parliament it is for the relevant Parliamentary Committee to decide what further investigations, if any, it wishes to undertake. This process is called post-legislative scrutiny. The assessment reviews the changes that the 2007 Act made to the Mental Health Act 1983 and in particular the issues that have been raised in connection with supervised community treatment and independent mental health advocate services. The 2007 Act amended the Mental Capacity Act 2005, to introduce a new regime of deprivation of liberty safeguards. The assessment therefore also considers the implementation of the deprivation of liberty safeguards system.

National confidential enquiry into suicide and homicide by people with mental illness: annual report - England, Wales, Scotland and Northern Ireland. This update of an annual report collects data on the number, trends and risk factors linked to suicide, sudden unexplained death and homicide amongst mental health patients in the UK.

Mental Capacity Act 2005, Deprivation of Liberty Safeguards assessments - England, 2011-12, Third report on annual data. This report provides information on uses of the legislation across the whole year from 1 April 2011 - 31 March 2012. This report also references the expected figures included in the planning assumptions made by the Department of Health.

Health and Social Care reform: Making it work for mental health. This report published by the All Party Parliamentary Mental Health Group highlights four areas of concern in mental health: commissioning; lost decision making; integrated care; and personalisation and patient choice.

Young people’s views and experiences of GP services in relation to emotional and mental health. This research was conducted to assess young people’s experiences of visiting their GP in order to identify responses they would like in relation to their mental and emotional health and what improvements are required to enable them to have a better experience.

Mental health implementation framework. The Government has published the Mental Health Implementation Framework, which sets out what organisations can do to make the 6 high-level objectives of the mental health strategy No Health without Mental Health a reality.

Ofsted: Good practice resource - Effective Child and Adult Mental Health Services - Buckinghamshire County Council. This example illustrates improving outcomes for children through good commissioning practices and pooling budgets to re-commission Tier 2 and 3 Child and Adolescent Mental Health Services at Buckinghamshire CC.

Investment in mental health - Working age adult and older adult reports. The working age adult and older adult reports map the level of investment in mental health services in England for 2011-12 for those age ranges.

2010/11 investment in mental health. These reports present the results of a survey into investment in mental health services. The analysis covers working age adults and older people and compares the results with previous years.

Costs of eating disorders in England: economic impact of anorexia nervosa, bulimia nervosa and other disorders focussing on young people. This report aims to provide a comprehensive view of the overall costs to society of eating disorders in England, especially amongst young people, and the costs to the NHS, employers and employees. It reveals that the overall healthcare costs are estimated at £80-£100m; costs of reduced GDP up to £2.9bn; and costs of reduced length of life and health up to £6.6bn.

Consultation
Consultation on new safeguarding power. Seeks views on a proposed duty on local authorities to make enquiries where there is a safeguarding concern and on powers to support this duty, e.g. a power of entry, enabling the local authority to speak to someone with mental capacity who they think could be at risk of abuse and neglect, in order to ascertain that they are making their decisions freely. The consultation closes on 12 October 2012.

Consultation on funding allocations for independent mental health services. In this consultation the Department is asking for your views on options for distributing funding to local authorities for Independent Mental Health Advocate (IMHA) services and the Armed Forces’ compensation disregard. From April 2013 the statutory duty and funding for commissioning IMHA services will transfer to local authorities. These services are currently commissioned by Primary Care Trusts. The consultation closes on 7 September 2012.

Law Commission: The defences of insanity and automatism - A consultation. This consultation seeks views on case law on the defences of insanity and automatism, whether the current law causes problems in application in practice and, if so, the extent of those problems.

Transforming the services of the Office of the Public Guardian. This consultation seeks views on changes that the Office of the Public Guardian is looking to make to deliver new user friendly services that take advantage of digital technology to assist in the making of Lasting Powers of Attorneys and in the supervision of deputies. 

News
Hillingdon Council to pay Steven Neary £35,000. A West London council has been ordered to pay £35,000 to an autistic man who was unlawfully detained in a care unit.

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

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Obesity 

Publications/Guidance
Memorandum: An update on the Government's approach to tackling obesity. This update was prepared for the Public Accounts Committee. It outlines the government's approach to tackling obesity in England.

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

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Primary Care

Publications/Guidance
The safer management of controlled drugs. This is the fifth annual report on the governance of controlled drugs, looking at the data collected from 2011. The report examines how the CQC and their partners have improved the management of controlled drugs and how changes in healthcare legislation are affecting the arrangements for safer management of controlled drugs. It also reports on the progress that has been made with the recommendations outlined in the 2010 report. Further recommendations to assure the safety of people who use health and social care services have also been made. Also published is a self-assessment tool to help PCTs measure their performance and identify ways in which they can improve their management of controlled drugs and improve safety. It includes a series of detailed questions around the safe management of controlled drugs, which PCTs can use to score their current practices.

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

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Prison Health

Publications/Guidance
National survey of hepatitis C services in prisons. This survey aims to collect basic information on what type of services are provided in prisons for the diagnosis, treatment and follow-up of prisoners infected by hepatitis C.

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

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Public Health

Publications/Guidance
The role of local authorities in health issues. From 1 April 2013 top tier local authorities will assume responsibilities for public health, and Health and Wellbeing Boards will be established as statutory committees responsible for encouraging integrated working and joint strategies on health and wellbeing. The Communities and Local Government Committee is inviting submissions from interested parties on the future role of English local authorities in health issues. The closing date for submissions is 18 October 2012.

Preventing type 2 diabetes: risk identification and interventions for individuals at high risk. This guidance is for everyone who is involved identifying people at high risk of type 2 diabetes and in preventing or delaying its onset.. This includes GPs, nurses and other health professionals, as well as commissioners and managers within the NHS, local authorities and the wider public, private, voluntary and community sectors.

Healthy transport = healthy lives. This report urges doctors to play a key role in reducing car use and calls on the government to take a long-term view of transport policy to create the conditions that reduce demand for car use, while enabling a shift to more active and sustainable forms of transport.

Public health briefings for local government. NICE has developed public health briefings for local authorities and their partner organisations that provide advice on the public health actions that are most effective and provide best value for money. The first three briefings cover tobacco, workplace health and physical activity. 

Structure of Public Health England. This factsheet sets out how Public Health England will be structured to achieve its ambitions of protecting and improving health and wellbeing, while reducing health inequalities. It also shows the proposed structure for when the organisation comes into being in April 2013, and will be used as the basis for transition. It aims to provide a guide for staff who will join the new agency and for its partners.

Public Health England people transition policy. This series of factsheets sets out the process and timetable for handling the transfer, appointment and redeployment of staff from sender organisations to Public Health England.

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
Winterbourne View Hospital - a serious case review. South Gloucestershire’s multi-agency Safeguarding Adults Board (SAB) has published the independent Serious Case Review into the events at the Winterbourne View private hospital. The review was commissioned by the SAB following the disclosure last year of the abuse of adults with learning disabilities and autism at the 24-bed private hospital owned and operated by Castlebeck Ltd. Prepared by independent adult safeguarding expert Margaret Flynn, the review shows that the abuse at Winterbourne View Hospital resulted from serious and sustained failings in the management procedures of Castlebeck Limited. It also identifies where other organisations’ systems and procedures fell short in commissioning patient care, and in reviewing and safeguarding the wellbeing of patients before and during their stay at Winterbourne View hospital.

Termination of pregnancy inspections. The findings of 249 individual inspection reports into providers offering termination of pregnancy services have been published by CQC. It investigated whether requirements, outlined in the Abortion Act 1967, are routinely met. The inspection found that adherence to the requirements varied across the country but that there is no evidence that any women had poor outcomes of care at any of these locations.

Consultations
The new NHS provider licence consultation. This provider licence will be a key tool for regulating providers of NHS services. It sets out various conditions providers must meet, including conditions relating to: pricing; preventing anti-competitive behaviour which is against the interests of patients; enabling integrated care; supporting commissioners to maintain service continuity; and the governance of foundation trusts. This consultation seeks views on the provider licence and it runs until 23 October 2012.

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

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General

Publications/Guidance
Interventions to reduced unplanned hospital admission: a series of systematic reviews. This research study evaluated several key interventions aimed at reducing unplanned admissions and identified those which are most effective. It found that unplanned admissions make up approximately 40% of hospital admissions in England and can increase problems for health services as they are costly, disruptive, and lengthen waiting lists.

National BAME Transplant Alliance Strategic Plan 2012/13 - 2014/15. The NBTA brings together people and organisations with in-depth knowledge of their communities to address the problem of low donor and transplant rates. This plan sets out their strategy to address the under-representation of black, Asian and minority ethnic (BAME) people on whole organ and bone marrow registers.

Healthy women, healthy lives? The cost of curbing access to contraceptive services This report is the result into an inquiry into restrictions of access to contraceptive services. It identified restrictions for women over 25; based on residence; and access to long-acting reversible methods of contraception through GP referrals. It makes recommendations to reduce inequality in access to contraceptive services for all.

The evaluation of the electronic prescription service in primary care. This interim report outlines the preliminary findings from the evaluation in early implementer sites for the Connecting for Health Evaluation Programme. It provides an initial evaluation of a new system that can provide electronic transmission of prescriptions from GP practices to community pharmacies. 

Improved NHS Services through new perspectives – A toolkit. Guidance from the Centre for Innovation in Health Management with a toolkit for doctors and managers to improve quality for patients. 

Remote prescribing via telephone, fax, video-link or online. This GMC guidance which came into effect on 23 July 2012 gives guidance on remote prescribing.

The way forward: strategic clinical networks. This report sets out plans for a small number of national networks to improve health services for specific patient groups or conditions. Strategic clinical networks, hosted and funded by the NHS Commissioning Board will cover conditions or patient groups where improvements can be made through an integrated, whole system approach. These networks will help local commissioners of NHS care to reduce unwarranted variation in services and encourage innovation. The conditions or patient groups chosen for the first strategic clinical networks are: cancer, cardiovascular disease (including cardiac, stroke, diabetes and renal disease), maternity and children’s services, mental health, dementia and neurological conditions.

Preparing for the Francis report: how to assure quality in the NHS. This paper examines how the system of quality assurance, including regulation, needs to evolve, the principles on which it should be built and how it should operate. It is intended to help to shape the debate about how quality can be assured in future and inform how organisations at every level of the system will respond to the challenges that the events at Mid Staffordshire NHS Foundation Trust have highlighted.

Consultations
The future of the Independent Living Fund (ILF). DWP is seeking views on the proposal to close the ILF in 2015, and for local authorities to take on the funding and responsibility for ILF users’ care and support. The paper also discusses how closure could be managed in a way which would minimise disruption to the care and support needs of existing ILF users. The consultation closes on 10 October 2012.

Proposal to introduce an early access to medicines scheme in the UK. This consultation is seeking views on proposals to introduce a scheme in the UK that will provide access to certain new medicines before they are formally licensed. Comments are being invited until 5 October 2012. 

Local Healthwatch regulations – a summary report of engagement. Healthwatch will be the new consumer champion for both health and social care. It will exist in two distinct forms – local Healthwatch, at local level, and Healthwatch England, at national level. Local Healthwatch will replace Local Involvement Networks (LINks), carrying forward the LINks functions while taking on new, additional functions. From April to June 2012 the DH sought views on issues around the local Healthwatch regulations. This report sets out the key issues that arose from discussions and provides information on the Department’s approach to the drafting of the regulations.

News
Health Secretary Andrew Lansley has accepted recommendations from UK immunisation experts to extend the flu vaccination programme to all children. Children in at- risk groups - such as those with asthma, heart conditions or cerebral palsy - are already eligible to receive the flu vaccine on the NHS. Once the programme is up and running the vaccine will be offered to all children aged two to around 17 years on the NHS.

Diageo agrees "multimillion dollar" settlement with thalidomide victim. Australian thalidomide victim, Lynette Rowe, has won a landmark compensation payment from the British distributor Diageo. Lawyers told the Australian Supreme Court that they had reached a confidential settlement in her case with Diageo. The case against Grunenthal will continue in Australia.

Kent criticised over two adult social care complaints. The LGO has found that Kent CC wrongly refused to pay for short-term residential care for an elderly woman, and delayed in providing services for a young disabled woman.

Bristol hospital trusts announce plans for £1bn merger. The merger of University Hospitals Bristol Foundation Trust (UHBFT) and North Bristol Trust (NBT) was approved by the board of UHBFT.

The House of Lords Science and Technology Committee have launched an inquiry into regenerative medicine - methods to replace or regenerate human cells, tissues or organs in order to restore (or establish) normal function.

Needle and syringe programmes: providing people who inject drugs with injecting equipment. This is an update of the NICE guidance on ‘Needle and Syringe programmes’ (PH18). This guidance was reviewed in 2011 and it was agreed that it should be updated. The final review decision can be viewed here.

Bevan Brittan Updates
What can you do when a contractor is unable to deliver? Reports published this week suggest that G4S, the private security firm tasked with keeping the London 2012 Olympics safe and secure, may be unable to supply all the guards it was contracted to deliver for the games.  Just 15 days before the opening ceremony, Theresa May has asked the British armed forces to provide a further 3,500 troops to fill the feared shortfall.

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

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